Male and Female Infertility Treatment | International Urology Centre

A fertile couple in their 20s having regular sex has around a 1 in 4 chance of getting pregnant each month. Conversely, infertility is defined as the inability to conceive even after a year. The sharp rise in infertility cases in Singapore is mainly due to people delaying marriage and starting a family past their prime childbearing years, causing the quality of both egg and sperm to be lower. However, it must be noted that even though much of the discussions around infertility tend to be centred on women, it is estimated that of the 1 in 7 couples who struggle with infertility, 50% to 60% are actually attributed solely or in part to the man – something that should not be overlooked.

Urologist, Dr Michael Wong was Faculty at the World Congress of Endourology in Abu Dhabi. Seen here with great friends ; Prof Chandru sundaram from Indiana University and dr png Keng siang from Singapore

What are the causes of male infertility?

Sperm Count

If a man has a low sperm count, the chances of one of his sperm fertilising an egg decreases drastically. According to the World Health Organisation, a healthy man’s semen should contain a minimum of 15 million sperms per millilitre. The normal volume of ejaculate should also be at least 1.5 millilitres.

Sperm Quality

Sperm quality can be determined by morphology – the size and shape of sperm, their genetic material, as well as their ability to move properly. If the sperm is abnormally shaped (with head or tail defects), it may not be able to penetrate an egg successfully. Sperm must also have good motility (to swim well) in order to travel past the cervix and all the way up the fallopian tube to meet the egg.

Sperm must also contain healthy and intact genetic material. When there is a high level of DNA fragmentation, the chances of conception falls significantly.

Medical Conditions

Certain medical conditions and medications can affect a man’s fertility. It goes without saying that one must be at his prime health to be able to produce sperm of optimal quality. As such, men should ensure that their medical problems are well controlled when trying to conceive.

They should also consult their doctors to find out if certain medications they are taking are affecting their fertility, and to work out an alternative arrangement for that for the time being.

Environmental & Lifestyle Factors

Sperm are very sensitive to heat – there is a reason why testicles are located outside of the body, in order to preserve sperm in a cooler temperature where they thrive in. As such, men who are trying to conceive should cut down on:

Saunas, placing laptop on their laps
Constrictive clothing
Exposure to toxic fumes (e.g. pesticides and chemicals)
Alcohol and smoking
Unhealthy eating or sedentary lifestyles – being fit helps in quality sperm production

What are 4 causes of female infertility?

Hormonal / Ovulation Disorders

Damaged or Blocked Fallopian Tubes

Certain Medical Conditions

(e.g. Endometriosis, PCOS, Uterine Fibroids & Polyps)

Age

Egg quality falls rapidly as women age past their prime childbearing years of their 20s

General Health

Infertility Treatments

The two main types of infertility treatments available are: Intrauterine Insemination (IUI) and In-Vitro Fertilisation (IVF).

The main difference is that in IUI, the man’s processed semen sample will be directly placed into the woman’s uterus to increase chances of fertilisation and conception; while in IVF procedure, fertilisation is done manually in a lab, with the fertilised egg/embryo (s) being transferred into the woman’s uterus thereafter.

The main goal of an IUI is to identify and concentrate the number of healthy sperm, and reduce the distance between the sperm and the egg in the fallopian tube, thereby increasing chances of fertilisation. This is also done when the woman is ovulating.

Though it is a less invasive and cheaper option, IUI is only more suitable for men with moderate to low sperm count; men with severely low sperm count should opt for an IVF treatment instead. It is also not suitable for women with damaged fallopian tubes, who should opt for an IVF treatment instead too.

Conversely, IVF procedure comes in 4 main steps: (1) Ovary Stimulation (to produce multiple eggs), (2) Egg Retrieval, (3) Fertilisation, and (4) Embryo Transfer.

At the International Urology, Fertility & Gynaecology Centre, we offer a unique opportunity for couples suffering from infertility to have a joint consultation with both our specialists – urologist and men’s health specialist, Dr Michael Wong; as well as with our gynaecologist and IVF doctor, Dr Julianah Abu.

This allows for the concurrent assessment of both the urological and fertility aspects of the man and the woman; which then allows for the efficient diagnosis and treatment of the root problem. After all, the two disciplines are often intricately linked.

For a detailed consultation and fertility assessment by our dedicated doctors, contact our IVF clinic at +65 6838-1212 today.

How common is infertility in Singapore?

Infertility in Singapore is affects approximately 15% of couples, who are facing difficulty conceiving even after 12 months of regular and unprotected intercourse. Furthermore, female factor infertility and male factor infertility play almost an equal role.

How can I boost my fertility?

Maintaining a healthy body weight, engaging in daily exercise, having a balanced and healthy diet, avoiding stress, and quitting smoking and alcoholic drinks can help improve male and female fertility. One can also visit a specialist so that targeted male and female fertility treatments may be received.

Can male infertility be treated?

Due to advancements in technology and medicine, the majority of male infertility cases can now be treated, or overcome. Some of these male infertility treatments include surgery, assisted reproductive technology (ART) like in vitro fertilisation (IVF) and intrauterine insemination (IUI), infection treatment, lifestyle changes, and hormone therapy.

Can an infertile man still have a baby?

In most cases, an infertile man, with the help of medication, surgery and ART treatments, can conceive his own biological child. In vitro fertilisation (IVF), in particular, has made conception possible for many men with low quantity or quality of sperm.

How can I check if my sperm is healthy?

The most accurate and comprehensive way to find out, is to get a semen analysis done at a medical facility. While home sperm tests exist, they are less accurate, basic, and not as well-studied.

What are the types of male infertility?

Some causes of male infertility include sperm disorders, varicoceles, retrograde ejaculation, immunologic infertility, hormonal changes and obstruction.

What are signs and symptoms of infertility in women?

The main symptom of infertility in women is the inability to get pregnant after a year of regular and unprotected intercourse (provided the male partner is fertile). Other possible signs to investigate may include period problems such as: irregular cycles, short, very heavy, or absent periods, etc.

What are the types of female infertility?

There are two types of female infertility: primary and secondary. Primary infertility refers to the inability to have ever gotten pregnant before; whereas secondary infertility refers to the inability to get pregnant again after having gotten pregnant before.

Can female infertility be cured?

With modern medicine and technologies, female infertility can usually be treated, or overcome. Depending on the cause of the infertility, women may have the option of receiving treatment through medications, surgeries, lifestyle changes, or assisted reproductive technology (ART).

At what age does a woman stop being fertile?

Women are most fertile between their late teens and late 20s. When they reach the age of 30, their fertility starts to decline. This decline intensifies as they reach their mid-30s; and by 45, their chances of getting pregnant naturally are very low. Even if women at an advanced age become pregnant, they are considered a high-risk pregnancy, and will need to be closely monitored.

How do you test a woman's fertility?

There are various tests that women can do in order to check their fertility. Some of these tests include imaging tests (to assess the structures of one’s reproductive organs), ovulation test (to assess if there is normal ovulation occurring), ovarian reserve test (to assess the number of eggs a woman has), and so on.

Do women still get a period if they are infertile?

Women who experience infertility can still have a monthly period. This is because not all infertility problems are due to ovulation disorders that affect one’s period.

Improve Male Fertility

Couples often find it distressing when they experience difficulty conceiving, when the cause is due to an issue with the reproductive system.

Infertility is a sensitive subject, but a very common one affecting 1 in 6 couples. About half of all infertility cases can be attributed to a male factor. Thankfully, most cases of infertility can be managed.

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Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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