Fertility in females can be affected by many factors, with genetics and physiological conditions being the top primary causes. If you and your partner have been trying for a baby but to no avail for the longest time, it could be a sign that you have some fertility issues. Generally, experts suggest that if you’ve had regular sex without any form of birth control for 12 months and are under the age of 35, then it’s best to check in with a women’s clinic in Singapore. If you’re over the age of 35 and have had regular sex without any form of birth control for 6 months, you should check in with your doctor too.
It’s important you see a doctor together with your partner, so the doctor can assess both your health and lifestyles. He/she will ask questions regarding:
- Medical history — do you or your partner have any long term conditions or undergone any surgeries?
- Medication — are either of you on any medication?
- Lifestyle — any of you smoke, drink alcohol, regularly consume caffeine, or use illicit drugs?
- Sex lives — how often do both of you have sex, any problems having sex, any history of birth control or sexually transmitted diseases?
In addition, your doctor will check if you have:
- Been pregnant before
- Missed periods over the last year
- Irregular spotting between periods
- Changes in blood flow or the appearance of large blood clots
- Seen a doctor for infertility, and what methods did you use?
What causes female infertility?
Female infertility happens when there are problems with producing a healthy egg, when the egg cannot be properly transported to the womb from the ovaries, or when the fertilized egg cannot implant itself into the womb.
Egg production problems can be caused by hormonal imbalances, which could be stress-induced or by conditions like Polycystic Ovary Syndrome. Sometimes, even when there is a healthy egg, the egg is unable to successfully travel from the ovaries to the womb to be fertilised by the sperm. This is caused by blocked fallopian tubes. Even if the egg successfully reaches the womb, it needs to be fertilised by the sperm and be able to implant itself in the lining of the womb. Unsuccessful implantation could be due to fibroids, endometriosis, polyps or cysts on the womb lining. When there are other growths on the lining, the surface area for the fertilised egg to latch itself is reduced.
Just imagine the womb lining to be like a bench — when there are too many people sitting on a bench, chances are, the next person will pass and walk away. Similarly, if the womb lining is over crowded, chances of the fertilised egg implanting itself is also reduced.
Testing for infertility
There is no single best test for infertility. Hence, doctors will use a variety of methods, including:
- Ovulation test — to check if you ovulate and produce a single egg each month
- Ultrasound scan — to check the lining of your womb for fibroids and cysts and conditions like endometriosis and Polycystic Ovary Syndrome. An ultrasound is especially important if you have never been examined by a gynaecologist and could have underlying gynaecological conditions that were previously undetected. Depending on what deems more suitable, the ultrasound is either performed trans-abdominally or trans-vaginally.
- Ovarian Reserve — a blood test to measure the level of your AMH hormone which can roughly estimate the number of eggs you have
- Pap smear — to detect cervical cancer or sexually transmitted diseases
- Sonohysterogram — to look at your ovaries, uterus and fallopian tubes
- Diagnostic Laparoscopy — a test performed under anaesthesia to have a closer look at your ovaries, uterus, fallopian tubes and pelvic cavity. Your doctor will make small incisions in your belly and insert tools like a mini camera.
- Transvaginal ultrasound — Your doctor will place a small ultrasound ‘wand’ into the vagina and see images of the ovaries and uterus to check for problems
- Hysterosalpingogram (HSG) — A HSG is a procedure performed either in the clinic or at an imaging centre. A thin tube is inserted through the vagina into the cervix and subsequently the womb. The tube contains medical dye and an X-ray is performed over the pelvic to examine the uterus, ovaries and fallopian tubes. A HSG procedure takes about 15-30 minutes.
In addition, your partner may also be required to take a sperm test. This sperm test can provide insights on sperm count, sperm structure and sperm motility.
Your doctor or fertility specialist will explain to you your condition in closer detail and recommend a treatment based on your situation.
What’s the next step after a fertility assessment?
Based on test results, your doctor or gynaecologist will ascertain whether you have a fertility problem and whether it can be corrected. He/she will discuss the various fertility options available, including:
- Well-timed sexual intercourse — Timing sexual intercourse with ovulation can increase chances of pregnancy by 10-12%. Your ovulation period can be tested with ovulation test kits, or follicular tracking by a gynaecologist for more accurate results. During follicular tracking, the gynaecologist will conduct non-invasive ultrasound scans to track the development of the egg.
- Clomiphene — Clomiphene is a medication to help produce eggs, so the chances of producing at least one egg a month is higher.
- Surgery — When endometriosis, fibroids or ovarian cysts are the causes of infertility, surgery can help manage such problems.
290 Orchard Road #14-10
Paragon Medical Centre