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Q: What does fertility treatment involve?
A: The treatment of infertility depends on the cause. For example, in the case of cysts, fibroids and blocked fallopian tubes, laparoscopic or key-hole surgery may help to improve chances. For problems related to abnormal ovulation, fertility drugs or injections may help to enable ovulation to occur in a more predictable manner.
For poor sperm count and quality, intra-uterine insemination or Assisted Reproductive Techniques (ART) may be required. ART refers to the use of laboratory techniques to bring the egg and sperm together outside of the woman’s body. ART may also be referred to as In-Vitro Fertilisation (IVF). ART generally involves several treatment stages.
First, hormonal injections are necessary to increase the number of eggs produced by your ovaries. Then, ultrasound scans and blood tests are used to assess the growth and maturity of your eggs. Once the eggs are ready, they are retrieved with the help of a vaginal ultrasound while you are under anaesthesia. The eggs are then fertilised with the sperm to form embryos before they are transferred back into your womb several days later.
Q: What must one consider before adopting such procedures?
A: In Singapore, a couple must be married to be eligible for assisted reproductive techniques. With increased age, there is also a higher risk of having foetal abnormalities such as Down Syndrome.
Q: Up to what age is a woman eligible for IVF?
A: It is usually appropriate for women up to 45 years of age, but it may be earlier depending on when she reaches menopause. Success rates for fertility treatment tend to be higher for women who are younger and have a good ovarian reserve. Success rates are typically around 30-40 percent but fall to 10-15 percent for women over 40 years of age.
Q: What lifestyle changes are suggested to increase a woman’s chance of conception?
A: Observe a healthy lifestyle and diet. Avoid smoking, excessive alcohol and caffeine. The diet should include folic acid supplements, which can reduce the risk of birth defects like spina bifida.
Q: How has public perception about fertility treatments evolved over the years?
A: Fertility treatment has been perceived as stressful, involving many injections over several weeks. However, as couples are now more open about the infertility diagnosis and treatment, they are also more supportive towards each other, which helps to manage the stress involved. Injection regimes have also been modified and simplified to become easier on the patient.
Q: What emotional costs can one expect while undergoing fertility treatments?
A: Going through fertility treatment can definitely be an emotional roller coaster. After the stress and expectations of such therapy, there is still a risk of miscarriage after a successful pregnancy result.
Dr Kelly Loi Consultant Obstetrician & Gynaecologist