Male infertility is typically attributed to 2 main causes, a problem with sperm production or sperm delivery. Sperm production problems include having low sperm count or producing sperms of low quality e.g. sperms with low motility or abnormal structures. Sperm delivery problems include blockage of sperm ducts, which prevent the sperms from entering the woman or erectile dysfunction.
Similarly, female infertility can be attributed to 3 causes, problems with egg production e.g. hormonal imbalances (natural or stress-induced), egg delivery e.g. blocked fallopian tubes and implantation of the fertilized egg e.g. in women with endometriosis, fibroids, polyps or cysts.
Some infertility causes will require the couple to go to the option of IVF directly. For example, in many instances of male fertility issues, the need to undergo IVF is higher.
To better understand the fertility status of the couple, the gynaecologist will usually perform the following:
- Comprehensive history tasking
- Ultrasound of the woman’s womb
- Blood tests for the woman (if required)
- Fallopian tube check via HSG (hysterosalpingogram), which is an X-ray of the woman’s pelvic area to visualize the uterus, ovaries and fallopian tubes
- Sperm test for the man
Fertility assessment is different from pre-conception screening in that it is meant for couples who have been trying to conceive without success.
It is recommended that the couple goes for the first consultation together. However, in the event that the couple’s schedules cannot match, it is highly advisable for the woman to come and see the gynaecologist first to avoid further delay in seeking help.
Based on the assessment and test results, the gynaecologist can confirm if there is indeed a fertility problem, and if the problem can be corrected. He or she will then go through the various fertility treatment options with the couple.
Any gynaecologist can perform a fertility assessment. However, a gynaecologist who sub-specializes in fertility will be able to customize your care with the key objective of increasing your chances of pregnancy within the shortest timeframe possible. These fertility experts are often also IVF certified, and if need be, will be able to see you through your entire fertility journey should you require IVF.
While there is still a strong stigma tied to infertility problems in Singapore and beyond, it is heartening to see more women speaking out about their problems and encouraging one another with their stories. For those facing issues with conceiving, remember, it is perfectly acceptable to seek medical help. Don’t miss the timing for the highest chances of conceiving.