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Fertility

A fertile couple in their 20s having regular sex has around a 1 in 4 chance of getting pregnant each month.

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.

Male Infertility

Male fertility is affected by:

01

Hormonal / Ovulation Disorders

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.

02

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.

03

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.

04

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

Female Fertility

Female fertility is affected by:

01

Hormona / Ovulation Disorders

02

Damaged or Blocked Fallopian Tubes

03

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

04

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

05

General Health

Fertility Treatments

The two main types of fertility 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, 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 instead. It is also not suitable for women with damaged fallopian tubes, who should opt for an IVF instead too.

Conversely, IVF 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 fertility specialist and gynaecologist, 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 us at 6838-1212 today.

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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