Dr Michael Wong is a USA-fellowship trained senior urologist with an exceptional international standing, having received some of the highest recognitions across three continents.
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Restore Your Urological Health.
Make an appointment with Dr Michael Wong to receive a tailored, supportive and targeted care plan.
One-stop diagnosis and treatment centre of excellence for your urological, fertility or gynaecological problems
Infertility
In Singapore, infertility affects around 15% of couples, and both female and male factors play a role in its development. Fortunately, there are various treatment options for infertility, from lifestyle modifications to advanced medical interventions such as in-vitro fertilisation (IVF). A consultation with a fertility doctor will help you discover the best options for your situation.
Medically reviewed by Dr Michael Wong, Medical Director & Senior Consultant Urologist
FAMS (Urology),FICS (USA),FRCS (Edinburgh),M Med (Surgery),MBBS (S’pore)
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
What Is Infertility?
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.
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 is determined by morphology (size and shape), motility, and genetic material. Abnormally shaped sperm may fail to penetrate an egg, while good motility (to swim well) is necessary for reaching the egg. Healthy genetic material is also crucial, as high DNA fragmentation reduces the chances of conception.
Urogenital Conditions
Conditions such as varicoceles, retrograde ejaculation, and azoospermia can cause male infertility by affecting sperm production or transport in the reproductive tract.
Medical Conditions
Certain medical conditions and medications can affect a man’s fertility. As such, men should ensure that their medical problems are well controlled when trying to conceive.
Immunologic Infertility
This occurs when antibodies mistakenly target and destroy sperm cells, reducing their motility or causing functional abnormalities. Although this is uncommon, it can hinder fertilisation by preventing sperm from reaching and penetrating the egg.
Hormonal Changes and Obstructions
Hormonal imbalances, such as low testosterone levels or high prolactin levels, can interfere with sperm production and quality, leading to infertility. Blockages in the reproductive tract can also prevent sperm from reaching semen.
Sexual Dysfunction
Conditions such as erectile dysfunction and premature ejaculation can hinder contraception. Additionally, the stress of infertility can worsen these sexual problems, creating a frustrating cycle.
Environment & 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.
As such, men who are trying to conceive should cut down on:
Saunas, placing laptops 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
Consult our fertility doctor to give you and your partner a better chance of starting a family.
The doctor will inspect the scrotal area for lumps or irregularities and review the patient’s medical history and conditions that may affect fertility.
Semen Analysis
The patient ejaculates into a container, and the semen sample is sent to a laboratory to identify sperm quality or detect issues with sperm production.
Transrectal Ultrasound
A small, lubricated probe is inserted into the rectum to visualise the prostate, seminal vesicles, and testicles, helping identify blockages or abnormalities.
Testicular Biopsy
A needle extracts tissue samples from the testicles for lab analysis to determine if sperm production issues are due to a blockage or abnormal sperm transport or delivery.
Scrotal Ultrasound
High-frequency sound waves generate images of the scrotal region to detect abnormalities like varicoceles, tumours, infections, cysts, or blockages in the testicles or surrounding structures.
Hormone Testing
A blood test can measure different hormone levels, such as testosterone and follicle-stimulating hormone (FSH), and detect any issues that affect sperm production and fertility.
Post-Ejaculation Urinalysis
This test detects the presence of sperm in the urine, which may indicate retrograde ejaculation, low sperm volume, or issues related to sperm movement.
Genetic Tests
This test identifies congenital or inherited syndromes that may affect sperm production or function, often recommended for patients with severely low sperm concentration due to Y chromosome alterations.
What Are 5 Causes of Female Infertility?
Hormonal / Ovulation Disorders
Damaged or Blocked Fallopian Tubes
Uncontrollable Medical Conditions
(e.g. Diabetes, Thyroid Conditions)
Gynaecological Conditions
(e.g. Endometriosis, PCOS)
Age
– Egg quality falls rapidly after 35, as women age past their prime childbearing years of their 20s
Infertility can be a source of stress, but you are not alone. Fertility specialists offer tests and treatments for both partners.
Schedule a consultation and take the first step towards building your family.
Depending on the underlying cause, there are various male infertility treatment options available. These include:
Intrauterine Insemination (IUI)
In this procedure, the man’s processed semen sample will be directly placed into the woman’s uterus to increase chances of fertilisation and conception. 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 the 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 mild to moderate low sperm counts.
In Vitro Fertilisation (IVF)
During the procedure, fertilisation is done manually in a lab, with the selected embryo(s) being transferred into the woman’s uterus thereafter. The IVF procedure comes in 4 main steps: (1) Ovary Stimulation (to produce multiple eggs), (2) Egg Retrieval, (3) Fertilisation, and (4) Embryo Transfer. Men with severely low sperm count should opt for an IVF treatment.
Other Assisted Reproductive Technologies (ART)
In addition to IUI and IVF, other assisted reproductive technologies (ART) may be recommended in certain cases. These include intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into an egg to facilitate fertilisation, and testicular sperm extraction (TESE), where sperm are surgically retrieved from the testicles.
Why Choose Our Clinic for Infertility Treatment?
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.
Your Fertility Questions Answered
How Common Is Infertility in Singapore?
Infertility in Singapore 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 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 tests (to assess if there is normal ovulation occurring), ovarian reserve tests (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.
Can Using Steroids for Bodybuilding Cause Infertility?
Prolonged use of anabolic steroids for bodybuilding or performance enhancement can affect sperm production and male fertility. This can suppress natural testosterone production, leading to a low (or absent) sperm count and shrunken testicles (testicular atrophy).
How Does Age Impact Male Fertility?
Men’s fertility typically declines around the ages of 40 to 45 due to lower sperm quality and testosterone levels. While they can remain fertile into their later years, the risk of genetic abnormalities in their offspring may increase.
What Lifestyle Changes Can Help Male Infertility?
While medical interventions may be necessary in some cases, adopting a healthy lifestyle can also improve male fertility. Consider the following:
Quit smoking
Limit alcohol intake
Avoid substance abuse
Limit exposure to toxic fumes
Maintain a healthy diet
Exercise regularly
Manage stress levels
If you or your partner are experiencing fertility challenges, our fertility clinic in Singapore provides comprehensive diagnosis and treatment for various fertility problems, with personalised care and tailored management plans to help couples achieve successful conception.
Let us help you Restore your urological health.
Make an appointment with Dr Michael Wong to receive a tailored, supportive and targeted care plan.
Office Location
3 Mount Elizabeth Road, #10-09, Mount Elizabeth Medical Centre, Singapore 228510
