Singapore Male & Female Infertility Centre

Definition

Infertility is generally defined as the inability to conceive after 1 year of actively trying i.e. having sexual intercourse 2-3 times a week.

When to seek help

After 1 year of trying, 80-90% of couples would have been successful in conceiving. It is therefore advisable to seek help at this point.

Fertility does decline with age. Studies have found that the probability of conception over a month falls from 25% in women in their early twenties to 8% in their late thirties. Similarly, the probability of conception within a year falls from 97% in women in their early twenties to 65% in their late thirties.

It is therefore important to start planning for a pregnancy as early as possible and to seek help as soon as there seems to be difficulty. It would also be advisable to seek help early if you are over 30 years, or if there are any indicators of infertility factors such as irregular or painful menstruation.

Causes of Infertility

Infertility may be due to male or female factors.

Causes of male infertility include:

• Low sperm count
• Poor sperm motility
• Poor morphology or shape, so that the sperm is unable to penetrate the egg

Causes of female infertility include:

• Hormonal disorders resulting in anovulation or a failure of egg follicles to grow and be released
• Blocked fallopian tubes, which will prevent an egg and sperm meeting
• Endometriosis, in which tissue of the lining of the womb invades and damages neighbouring reproductive tissue

Often, there is a mixture of both male and female factors. In some cases, there appears to be no obvious reason and this is termed ‘unexplained infertility’.

Investigations

Basic investigations of infertility include a semen analysis and, for the female partner, hormone tests and an ultrasound scan of the pelvis. Depending on the medical history and basic investigation results, advise will be given on the method of testing for patency of the Fallopian tubes.

Options for testing tubal patency include:

• a radiological dye test called ‘hysterosalphingography’ or
• hydrotubation at the time of minimally invasive laparoscopic surgery

Some women may be recommended a hysteroscopy to assess the cavity of the womb. This test involves visualizing the cavity of the womb with a fine telescope to ensure that that the cavity of the womb is healthy. Any polyps found will be removed. These are all considered preparation for Infertility treatments, such as In-Vitro Fertilization (IVF) and Intrauterine Insemination (IUI).