DR KELLY LOI

OBSTETRICIAN AND GYNAECOLOGIST OF HEALTH & FERTILITY CENTRE FOR WOMEN

Singapore’s declining birth rate is made worse by the many requirements today’s society places on the modern couple: the busy lifestyles of both men and women mean less time and opportunity to try and conceive, and the pressure to work while we are still young means that women are delaying childbirth more and more.

However, all women are born with a fixed number of eggs; and as we grow older, not only does the egg count fall, egg quality also declines, and the risk of medical - in particular, gynaecological - health issues increases.Of course, the “blame” does not fall squarely on the shoulders of women. Common causes of infertility in men include poor sperm count and/or poor sperm quality, which in turn are commonly caused by unhealthy lifestyle habits such as smoking or excessive drinking.

If one wishes to keep one’s self in optimal child-bearing condition, both men and womenshould keep themselves fit and healthy by eating a diet rich in fruits, vegetables and other food rich in antioxidants and remember to exercise regularly. Start planning for a family as soon as it is possible, as it becomes increasingly more difficult for both men and women to have children as they get older. If lubricants are used during sex, try to make sure that they are suitable for conception: many commercial lubricants also double as spermicides, making conception particularly difficult if they are used.

For women in particular, try to limit coffee intake to one cup a day; high levels of caffeine have been associated with decreased fertility and an increased risk of miscarriage. It is also a good idea to have a steady intake of folic acid as it has been noted to decrease the risk of birth defects such as spina bifida.

Men should also take care to wear loose-fitting undergarments, especially on hot days, and avoid extremely hot temperatures such as those found in spas, saunas and hot tubs: sperm thrive in cooler environments, which is precisely why the scrotum hangs outside of the body: to keep the testicles cool.

I think it is especially important to note the role that stress plays in fertility. Not only does stress often lead to tiredness and a lower libido - and thus less attempts at making a baby - stress also affects your chances of conception. Sadly, many couples who go through fertility treatments and fail tend to become stressed by that very failure, leading to an unfortunate cycle that loops back on itself. It is thus necessary that couples recognise the role that stress plays in fertility and take appropriate measures to regularly “de-stress”.

If the woman is menopausal or if they have gone through multiple failed IVF attempts with a poor response to hormonal stimulation, it may be advisable for the couple to stop trying. Either case may be an indication that there are insufficient eggs left in the woman; consult with your medical practitioner to explore other alternatives.

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