Singapore is facing a declining birthrate partly because time is a highly prized commodity, which is spent on work but not
sex. Although paucity of sex due to lack of time and stress is a personal issue, it becomes medicalised when it results
in subfertility. It is not uncommon for couples to tell me they have sex only once a month or only on weekends. Another
common reason is the older female partner whose natural fecundity is reduced. Lastly, the male factor is still largely undiagnosed
and remains an area where research and development of treatment is lagging behind the female. Hence, in my practice, the
male partner is as important and he is seen at the beginning as well by our in-house urologist, Dr Michael Wong. This allows
for a complete fertility profile of the couple to be made early on in their assessment.
It is a misconception that women have a larger role than men in infertility. In general, the causes of subfertility is 30
percent attributed to the female, 30 percent to the male and 30 percent where both male and female factors are present.
In 10 percent, there is no obvious cause as in Idiopathic Subfertility. Hence the male contributes to 60 percent of the
problems of subfertility, similar to the female. Having said that, the burden of receiving treatment is largely placed on
the shoulders of the female partner because she is the one going through procedures such as IVF and bearing the child. Hence,
even if the cause of subfertility is entirely a male factor such as in azoopermia, the female partner undertakes a larger
share of the burden of treatment. Whatever the cause may be, I believe both male and female partners play an equal role
to make the journey towards conception. Fertility treatment is highly emotional, so a supportive and loving male partner
makes a huge difference.
Plan to have a child before 35 if you desire more than one, avoid unsafe sex, maintain a normal weight to height ratio,
don’t smoke, no drugs, regular moderate exercise, eat a balanced diet with good amounts of greens and fruits, take folate
supplements and have regular sex with your loved ones.