Thinking of starting a family? Dr Kelly Loi of the HEALTH & FERTILITY CENTRE FOR WOMEN answers common questions on factors affecting fertility.

Q. How should newlywed couples prepare for pregnancy?

A. The woman should undergo preconception health screening three to six months before trying to conceive. This screening checks for any underlying health issues, allows time for treatment for any medical condition and optimises your chances of getting pregnant. A preconception health screening test includes a detailed medical consultation and physical examination, a cervical Pap smear and a pelvic ultrasound scan to determine if there are any cysts or fi broids which may need to be removed. Blood tests are also conducted to assess for the blood type, blood count, any infections and rubella immunity. If you’re not immune to rubella, a vaccination is recommended to prevent the risk of congenital rubella in the baby which can lead to many serious birth defects.

Q. When and how should cysts or fibroids be removed?

A.Not all cysts or fi broids need to be removed. It depends on their size, the risk of cancerous change, and whether they’re affecting your menstrual cycle or increasing menstrual pain. Sometimes, removal may be recommended to increase the chances of falling pregnant. Most cysts and fi broids can now be removed through minimally invasive laparoscopic surgery, also known as keyhole surgery. This surgery involves making very tiny incisions in your skin to insert a fi ne telescope and instruments. Recovery time is swift and you’re usually home in one or two days, if not on the day of the surgery itself.

Q. What are the causes of infertility?

A.Fertility problems may arise due to inconsistancies in the male or the female reproductive system. Problems with the male reproductive system include impaired sperm count and quality while females suffer from a broader range of issues such as ovulation disorders, endometriosis – where the lining of the womb is deposited over the uterus and ovaries – and fallopian tube disease, which prevents the egg and sperm from meeting.

Q. When should a couple visit a fertility specialist?

A. Infertility is defi ned as the inability to conceive after one year of unprotected sexual intercourse. Up to 90 percent of couples should have conceived by the end of the fi rst year of trying and if they haven’t, they should get a check up. Older couples should see a specialist after six months – especially if the woman is over the age of 35. An early visit to a specialist is also best if the woman has a history of abnormal menstruation such as amenorrhoea (no periods), oligomenorrhoea (infrequent periods), dysmenorrhoea (painful periods), pelvic infl ammatory disease (PID), or had any previous surgery. In such scenarios, the likelihood of gynaecological disorder is high. Early diagnosis and treatment is crucial for the successful management of infertility, so don’t procrastinate visiting a fertility specialist if needed.

Dr Kelly Loi Consultant Obstetrician & Gynaecologist

Health & Fertility Centre for Women is every modern woman’s partner in health, meeting all your medical needs, from fertility management, delivery, through to motherhood and beyond, using state-of-the-art facilities within a safe and comfortable environment.