For the 7 over billion people on planet Earth, the year 2020 will be anything but normal. However, in spite of quarantines, the pandemic has done more in this year than the last one hundred to bring us together as one global nation. As the year closes, Dr Navdeep shares his conviction on preserving fertility for the nation as he reinstates his firm and steadfast belief that nobody is infertile.
In 2018, it was revealed that the fertility rate in Malaysia was at its lowest in the last 55 years. At 1.8 babies per woman, it was a 1.3% drop from 2017, which recorded 1.9 babies per woman. Plainly put, this implies that the number of children produced by a woman during her reproductive years is insufficient to replace herself and her partner.
Whilst it is true that the age factor constitutes to female infertility, it is only one facet of infertility. There are other causes that afflict men and women, some of which are beyond our control but many of which are well within our responsibility.
Thus, it is very possible for us to preserve the state of fertility of our nation, of course spurred by the coming together of policy and people to make it happen.
Recently, we have seen a dramatic rise in countries actively taking up the banner to protect and restore national birth rates. These include initiatives by governments, private organisations and people from all walks of life.
A report in the Financial Times in November of this year highlighted the Japanese Prime Minister’s call for in vitro fertilisation to be covered on the national health insurance to raise Japan’s fertility rate, which stood at 1.36 children per woman in 2019.
In January this year, Prime Minister Viktor Orban announced that Hungary will provide free in vitro fertilisation treatment to couples at state-run clinics to address the country's population that has been falling steadily for four decades.
Down south, Singapore’s dropping birth rates have prompted its government to encourage privately run companies, organisations and community groups to come together to promote the value of family, alongside government programmes that help couples marry, start and bring up their families.
Similarly in the United Kingdom, private organisations are mooting ideas and initiatives to make the UK the safest place in the world to give birth vis-a-vis pre-conception campaigns.
On the home front, the availing of Employee Provident Funds for fertility treatment is a sign that something has to be done to arrest the birth rate downward spiral.
For no lack of trying, addressing infertility is and continues to be a daunting task. The truth of the matter is infertility is multifaceted and we must be aware of all probable premises. There really is a lot more, besides women having babies later, that adds up to falling birth rates.
Endometriosis, a painful disease encountered by women, can lead to infertility. Often times, sufferers, find it difficult to get a medical professional to pay attention to their complaints. Endometriosis is a very real threat to infertility and we should pay more attention to patients with complains of bad stomach cramps.
Polycystic Ovarian Syndrome (PCOS), also a common occurrence, affects how the ovaries work and impedes ovulation, thus leading to infertility. Unfortunately, unless a patient sees a doctor, PCOS can go largely undetected.
For those who know me, you would know my position on male infertility. Although there is rising awareness among couples that both husband and wife may be party to infertility, there are still gentlemen who are blindsided by the fact that they could be the cause of the condition. I believe that with adequate awareness, more couples will step forward together to get themselves checked.
Other troubling factors include diseases such as cancer. As many as 10 percent of cancer diagnoses are made to those under the age of 45 and aggressive treatments may result in infertility or sterility for some. In such scenarios, it is important that we are aware of our fertility options such as Oocyte Preservation.
Not the least is the ubiquitous question of lifestyle. There is an alarming concern about maladies such as diabetes, hypertension and obesity. Observing a healthy and balanced lifestyle from the time one is a child is the only way to transcend these problems – but can we opt to choose health over unhealthy nutritional habits?
Taking care of one’s health, educating the young and couples on preconception health and paying more attention to women and men’s health issues that could potentially lead to infertility could make all the difference in building a thriving population for our country.
The advancements and strides made in Assisted Reproductive Techniques (ART) over the decade offer much hope to couples but the pressing issue is how this help would be made accessible to those in need. Surely, concerted and complementary efforts from both government and private practices could pave the way for us to see exponential benefits.
A curative approach could mean that fertility services are made the mainstay in all government hospitals as with subsidised options for costlier procedures. A preventive approach could come in the form of fertility preservation awareness in schools, whilst an intent to encourage couples to have larger families could come in the form of better and bigger tax rebate incentives.
It would also do well if insurance organisations consider making infertility coverage pertinent as should medical practitioners be in the timely referral of patients for fertility-related specialist help.
Personally, I believe that nobody is infertile. We all just need a little help along the road of building a family.
Dr Navdeep Singh Pannu is a Fertility Specialist whose effervescent personality and positive attitude continue to be a source of comfort to couples on their quest to build a family.
He is the Medical Director of TMC Fertility and Women's Specialist Centre, which has been recently awarded the 2020 Malaysia Fertility Company of the Year by Frost and Sullivan 2020 Best Practices Awards.