What is Infertility?


Q1. What is the definition of infertility?

A couple is considered infertile if they have failed to get pregnant after a year of regular and unprotected intercourse.


Q2. When should one seek medical advice?

In the absence of known physical problems, a couple is advised to seek medical advice if they have attempted pregnancy on their own for a year but failed. If there are known physical causes, e.g. irregular period or a history of gynaecological problems, please consult a doctor while planning pregnancy or seek medical advice beforehand.


Q3. What are the common causes of infertility?

Infertility can be with the man or woman. The male-related factor has to do with sperm quality. Low sperm count, poor sperm motility and low sperm morphology are the common causes of male infertility. Female infertility may be caused by irregular period. The most common cause is Polycystic Ovaries Syndrome (PCOS), which can lead to irregular ovulation and reduce the chance of conception. Other possible causes include tubal problems, such as blockage in the fallopian tubes. Gynaecological problems may also lead to infertility, such as endometriosis, uterine fibroids, etc. All in all, 30% of infertility cases are caused by unknown reasons.


Q4. How is infertility diagnosed?

Seek medical advice if you are worried about infertility. Doctors will order different diagnostic tests to try to identify the causes. Women may consider follicular monitoring for any ovulation problems, or hysterosalpingography (HSG) for fallopian tube blockage. Additional tests may be ordered based on the clinical condition. For males, a semen sample is obtained for quality analysis.


Q5. What are the treatment options?

Infertility treatments depend on the causes of infertility. If the wife has irregular ovulation, doctors may prescribe medication to promote ovulation. For other causes such as blocked fallopian tubes, surgery may be needed to unblock the tubes. Other problems such as endometriosis or uterine fibroids may also require surgical treatment. For male infertility, intra-uterine insemination may be considered in case of poor sperm quality, or in-vitro fertilisation if sperm impairment is severe.


Q6. How can I increase the chance of pregnancy?

Those who plan pregnancy should maintain a balanced diet and avoid cigarettes and alcohol. Women may also consider taking folic acid. An optimal body weight is also important. In case of overweight, try to maintain a BMI of 25 or below through exercise and diet. If the female partner has regular periods, it is recommended to have intercourse starting from day 8 to 10, most ideally once every 2 to 3 days. It may increase the chance of sperm meeting the egg at the time of ovulation.

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