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Infertility Treatments in Singapore
Dr Michael Wong, Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh), M Med (Surgery), MBBS (Singapore)
When conception takes longer than expected, many couples in Singapore begin to seek clearer answers about their fertility. Months can extend into years of uncertainty and repeated disappointment, while the goal of starting a family remains out of reach. This is often when reliable assessment and appropriate treatments matter. Modern reproductive medicine offers possibilities that were not available in the past, helping couples move forward with clearer information and realistic choices.
At the International Urology, Gynaecology & Fertility Centre, our expertise in fertility care is built on clinical precision and proven techniques. We understand that navigating infertility is an emotional experience that can test even the strongest relationships. Whether you have just begun seeking answers or you have felt your hope slipping away, our team is here to support you with personalised guidance and appropriate treatment options. Starting a family deserves dedicated care, and we are committed to walking this journey with you.
Dr Michael Wong was a faculty member 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
Understanding Infertility and Its Prevalence in Singapore
Infertility and subfertility have become increasingly common in Singapore, with about 15% of couples experiencing challenges in conceiving. Normally, a fertile couple in their 20s who have regular intercourse has a 1-in-4 chance of achieving pregnancy each month. When conception does not occur after a year of trying, it is medically defined as infertility. Subfertility, on the other hand, refers to reduced fertility where pregnancy is still possible but may take longer. These issues can arise from female or male factors, or a combination of both partners’ health conditions.
One of the main reasons for the drop in Singapore’s fertility rates is that many people are choosing to marry and start families later in life. As people delay parenthood, the quality of eggs and sperm naturally declines, which can make conception more challenging. Although infertility discussions often focus on women, male factors are just as significant. In fact, among the 1-in-7 couples who struggle with infertility, about 50–60% of cases are attributed solely or partly to the man.
The good news is that modern fertility care offers a wide range of solutions, from lifestyle changes to advanced medical treatments such as in vitro fertilisation (IVF). Speaking with a fertility doctor is the first step to understanding your situation and identifying the best possible path forward.
Causes of Infertility in Men and Women
Common Causes of Male Infertility or Subfertility
Male infertility can stem from issues related to sperm production, sperm function or the ability of sperm to reach the egg. Below are the most common categories.
Sperm Count and Semen Quality
A low sperm count significantly reduces the likelihood of fertilising an egg. According to the World Health Organization (WHO), healthy semen should contain at least 15 million sperm per millilitre and a minimum ejaculate volume of 1.5 millilitres. Quality also matters. Sperm must have normal morphology and good motility to reach and penetrate the egg, and healthy genetic material is essential for successful conception. Furthermore, high DNA fragmentation can reduce fertility potential.
Hormonal Imbalances and Reproductive Tract Issues
Urogenital and Medical Conditions
Several urogenital conditions can affect male fertility by disrupting sperm production or transport. Varicoceles can impair sperm development, while azoospermia may result from blockages in the reproductive tract. Chronic prostatitis may influence semen quality through inflammation, and retrograde ejaculation can prevent semen from being released normally. Broader medical issues, including diabetes or thyroid disorders, may also interfere with hormone levels, sperm development or ejaculation.
Immunologic Infertility
Sexual Dysfunction
Erectile dysfunction, premature ejaculation and other forms of sexual dysfunction can hinder conception. The emotional stress of infertility can make these issues worse, creating a cycle that further complicates attempts to conceive.
Environment & Lifestyle Factors
Sperm are highly sensitive to heat and toxins. Prolonged exposure to high temperatures, such as from saunas or placing laptops on the lap, can affect sperm production. Tight clothing, smoking, excessive alcohol, pesticide exposure and poor diet or exercise habits may also reduce sperm quality. The use of anabolic steroids for bodybuilding can also disrupt hormone production and lower sperm output, which may lead to temporary or prolonged fertility issues.
Common Causes of Female Infertility
Hormonal and Ovulation Disorders
Ovulation disorders are the most common cause of female infertility. Conditions such as polycystic ovary syndrome (PCOS) or hypothalamic dysfunction can disrupt the release of mature eggs, leading to irregular or absent menstrual cycles and reduced chances of pregnancy.
Damaged or Blocked Fallopian Tubes
The fallopian tubes serve as the pathway between the ovaries and the uterus. Blockages or damage from pelvic inflammatory disease, previous infections or surgery can prevent sperm from reaching the egg or stop a fertilised egg from reaching the uterus. This is a frequent cause of subfertility.
Uncontrollable Medical Conditions
Chronic medical issues such as diabetes, thyroid disorders or autoimmune diseases can interfere with ovulation patterns, egg quality or the uterine environment. Certain treatments for these conditions, such as chemotherapy, can affect ovarian function by reducing egg quantity and quality.
Gynaecological Conditions
Endometriosis and uterine fibroids are two common gynaecological conditions that can affect fertility. Endometriosis involves uterine tissue growing outside the uterus, while fibroids are noncancerous growths within the uterus. Both can cause inflammation, scarring or structural changes that make it harder for an embryo to implant.
Age
Female fertility naturally declines with age. Women older than 35 experience a measurable drop in egg quantity and quality, with a more significant decline after age 40. Age-related fertility issues can increase the risk of miscarriage and make conception more challenging.
Unexplained Infertility
In some cases, standard fertility tests show no clear cause. This is known as unexplained infertility and affects up to 25% of couples seeking fertility care. Although the reason is unclear, many people with unexplained infertility still conceive with targeted treatments such as ovulation support, IUI or IVF.
Secondary Infertility
Secondary infertility refers to difficulty conceiving after previously having a child. Age, changes in health, weight, stress, hormonal shifts or new medical conditions can all contribute. Although it can be emotionally challenging, there are effective treatment options to help individuals and couples expand their families.
Consult our fertility doctor to give you and your partner a better chance of starting a family.
When to Seek a Fertility Assessment and What to Expect
A fertility evaluation begins with a review of your medical history and a physical examination. Your doctor will ask about your general health, past illnesses, medications and any symptoms that may affect your reproductive system. After this initial assessment, more specific tests are carried out based on whether the evaluation is for male or female fertility.
Fertility Tests for Men
Semen Analysis
This is the primary male fertility test. The patient provides a semen sample, which is examined in a laboratory to measure sperm count, motility, morphology and semen volume. This helps identify issues with sperm production or function.
Blood Tests
Hormone and genetic testing are carried out using a standard blood draw. Hormone tests measure levels that regulate sperm development, while genetic tests look for chromosomal abnormalities or Y chromosome microdeletions linked to very low sperm counts. Together, they help identify internal factors that may affect fertility.
Ultrasound Imaging
Scrotal and transrectal ultrasounds use high-frequency sound waves to assess the testicles, prostate and surrounding structures. Scrotal ultrasound can detect varicoceles, cysts, tumours, infections or blockages. Transrectal ultrasound is used to evaluate the prostate and seminal vesicles and can identify obstructions in the ejaculatory ducts.
Post-Ejaculation Urinalysis
If retrograde ejaculation is suspected, a urine sample is collected immediately after ejaculation and examined for the presence of sperm. Finding sperm in the urine can confirm that it is flowing backwards into the bladder rather than exiting through the urethra.
Testicular Biopsy
A biopsy may be recommended when semen analysis shows no sperm. A small needle is used to remove tiny samples of testicular tissue. The tissue is examined to see whether sperm are being produced but are unable to leave the testicle, which helps clarify the cause of azoospermia and guide treatment.
Fertility Tests for Women
Hormone Blood Tests
Transvaginal Ultrasound
Hysterosalpingogram (HSG)
Additional Diagnostic Options
Infertility often raises difficult questions, but a thorough assessment can provide direction. Fertility specialists offer comprehensive testing and treatment for both partners.
Schedule a consultation at our fertility clinic and take the first step towards building your family.
Infertility Treatments Offered in Singapore
Fertility care today offers far more possibilities than many people realise. Once the cause of infertility is understood, there are many treatment paths that can help you move closer to the family you hope to build. Some options focus on gently supporting natural conception, while others use advanced reproductive technology to overcome more complex challenges. Every treatment plan is shaped around your diagnosis, your goals and the pace that feels right for you. With thoughtful guidance and the right medical support, many individuals and couples discover that they have more hope and more options than they once believed.
Medication
Fertility medicines can stimulate ovulation in women with ovulation disorders or support egg development during treatments such as IVF. These medicines are carefully prescribed and monitored to ensure safety and effectiveness throughout each treatment cycle.
Surgery
Surgery may be recommended to correct structural issues that affect fertility. This can include removing fibroids, treating endometriosis or repairing blocked fallopian tubes. Minimally invasive approaches such as laparoscopy are often preferred for faster recovery and improved outcomes, especially when other treatments have not been successful.
Sperm Retrieval Procedures
For men with obstructive azoospermia or other conditions that prevent sperm from appearing in the semen, specialised procedures can retrieve sperm for use in assisted reproduction. Common methods include testicular sperm extraction (TESE) and percutaneous epididymal sperm aspiration (PESA).
In Vitro Fertilisation (IVF)
IVF treatment involves fertilising eggs with sperm in a laboratory, then transferring the resulting embryo into the uterus. Treatment generally includes four steps: ovarian stimulation, egg retrieval, fertilisation and embryo transfer. IVF may be recommended for various fertility challenges, including severe male infertility.
Intrauterine Insemination (IUI)
IUI involves placing processed, high-quality sperm directly into the uterus during ovulation to improve the chances of conception. This reduces the distance sperm need to travel and increases the likelihood of fertilisation. IUI is a less invasive and more affordable option, typically suited for mild to moderate male infertility or unexplained infertility.
Other Assisted Reproductive Technologies (ART)
Additional ART options may be recommended depending on the cause of infertility. Intracytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into an egg. It is often used when sperm quality is low. Sperm retrieval procedures can also be combined with ART to enable conception in cases of obstructive or non-obstructive azoospermia.
Our Coordinated Approach to Your Fertility Journey
At the International Urology, Fertility & Gynaecology Centre , patients have access to a level of coordinated care that is uncommon in fertility treatment. Our clinic offers the opportunity for a joint consultation with both our specialists: Dr Michael Wong, our urologist and men’s health specialist, and Dr Julianah Abu, our gynaecologist and IVF doctor.
This team-based approach allows both the male and female aspects of fertility to be assessed at the same time. By understanding each partner’s health together, our doctors can identify the root cause more efficiently and recommend a treatment plan that addresses the full picture. Because urological and gynaecological factors are often closely connected, this combined expertise ensures that patients receive comprehensive, thoughtful care from the very beginning.
Frequently Asked Questions About Male and Female Infertility
How common is infertility in Singapore?
What are the main causes of infertility?
What infertility treatments are available?
What are typical success rates for infertility treatments?
How do you test a woman’s fertility?
What can I do to support my fertility?
Our Fertility Specialist
Dr Michael WongHe serves as President of the American-based Endourological Society and World Congress of Endourology and Uro-Technology for 2026, a role that reflects his leadership in minimally invasive surgery and innovation. He has also been honoured with major international appointments, including the American Urological Association Global Leadership Award and long-standing editorial roles with BJUI. Dr Wong completed three USA postgraduate programmes in endourology, female urology and robotics, which support his focus on minimally invasive treatments for male fertility, urinary stones, prostate conditions, cancer and female urinary dysfunction.
Let us help you
Restore your urological health.
Make an appointment with Dr Michael Wong to receive a tailored, supportive and targeted care plan.
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