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What is secondary infertility? Secondary infertility can be a painful setback for a couple that hopes to expand their family. It refers to the inability to conceive or carry a pregnancy to term despite having had a successful pregnancy in the past. While primary infertility, or the inability to have a first child, receives greater attention, the inability to get pregnant again is a growing concern that affects millions of families around the world. This condition can take a toll on a couple’s physical, emotional, and mental well-being, making it essential to recognize, understand and address the challenges that come with it. What causes secondary infertility? Secondary infertility in female This condition is often overlooked because of the misconception that having previous successful pregnancies would mean subsequent pregnancies will occur naturally. If you are wondering how common is secondary infertility, it occurs at about the same rate as primary infertility. It affects about 12% of the women trying for another child. Here are some causes that affect the secondary fertility problem as much as the primary one. –       Age As women age, their fertility naturally declines. It is due to decreased quantity and quality of their eggs. This decline typically starts around age 30 and accelerates after age 35. As a result, women trying to conceive later in life may have more difficulty becoming pregnant than when they were younger, even if they have previously had successful pregnancies. –       Ovarian reserve Women are born with a finite number of eggs, and this number naturally declines as they age. Women who have previously had successful pregnancies may have a lower ovarian reserve, making it more difficult for them to conceive again. –       Uterine issues The uterus or womb is where the fertilised egg implants and grows into a fetus/baby. Thus, any issues with the uterus can impact a woman’s ability to conceive and carry a pregnancy to term. Secondary infertility may be caused by fibroids, scarring or adhesions within the uterus, and polyps. These causes may interfere with implantation or cause miscarriage. –       Fallopian tube issues The fallopian tubes transport the egg from the ovary to the uterus/womb. If the tubes are blocked or damaged, it can prevent the egg from reaching the uterus and being fertilised by sperm. Some complications may occur in the form of chlamydia, gonorrhoea and pelvic inflammatory disease. –       Endometriosis Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. In some cases, endometriosis can lead to secondary infertility. The scarring and adhesions caused by endometriosis can interfere with the normal function of the fallopian tubes and uterus. It can make the egg and sperm difficult to fertilise and implant in the womb. –       Polycystic ovary syndrome (PCOS) PCOS is a hormonal disorder that affects women of reproductive age. It’s one of the most common causes of female infertility and can contribute to the condition. Women with PCOS typically have elevated levels of androgens (male hormones), which can interfere with ovulation and make it more difficult for the egg and sperm to meet. It can result in irregular or absent menstrual cycles, making it harder for a woman to conceive. –       Secondary unexplained infertility Unexplained infertility can be a frustrating and challenging issue for couples. It may be due to age-related decline, changes in hormone levels, or lifestyle modifications. Regardless of the cause, it is essential to recognise and address the problem with the same urgency and sensitivity as primary infertility to increase the chances of conceiving. Secondary infertility in male Male infertility can be a contributing factor in cases of secondary infertility. Male infertility is responsible for up to 50% of all infertility cases. Several factors can cause male infertility, including: –       Low sperm count or poor sperm motility If a man has a low sperm count or poor sperm motility, it can make it more difficult for the sperm to fertilise the egg. According to World Health Organisation (WHO), a healthy sperm count should be around 15 million per millilitre ejaculation or at least 39 million per ejaculation. Any amount lower than the optimal level is considered to have a low sperm count. –       Abnormal sperm shape If a man’s sperm have abnormal shapes, it can also cause fertility problems. It is due to difficulty when penetrating the egg. –       Blockages or other structural issues If a male has blockages or other structural issues in his reproductive system, it can interfere with the normal flow of sperm. Some common causes of blockages and structural problems may be vasectomy, Epididymitis (inflammation of the tube that transports sperm) and genetic causes. –       Lifestyle factors Lifestyle factors also play a role in affecting secondary infertility. Factors such as smoking, excessive alcohol consumption, and being overweight or underweight can all impact fertility. Many factors can contribute to the fertility problem, and it’s often a combination of factors that leads to difficulty conceiving. It’s crucial for couples who are struggling with secondary infertility to work closely with a doctor to know what causes secondary infertility and develop a personalised treatment plan. How to diagnose secondary infertility? Diagnosing the problem involves thoroughly evaluating both partners to identify any underlying fertility issues. The diagnostic process typically begins with a comprehensive medical history and physical exam, followed by tests and procedures to evaluate fertility and identify potential problems. For women, the diagnostic process may involve the following: Ovulation testing Ovulation testing involves tracking a woman’s menstrual cycle to determine if and when she is ovulating. It can be done using ovulation predictor kits, basal body temperature monitoring, or ultrasound. Hormone testing Hormone testing involves measuring the levels of various hormones in a woman’s blood. It includes Follicle-Stimulating Hormone (FSH), Luteinising Hormone (LH), estrogen, and progesterone. Abnormal hormone levels can indicate issues

How to Boost Male Fertility? If you and your partner are trying to conceive but facing difficulties, you may be wondering how to boost male fertility. While there are many factors that can affect fertility, male infertility is a common contributor. The good news is that there are several steps men can take to improve their reproductive health and increase the chances of conception. From simple lifestyle changes to natural supplements, there are many options to consider. Let’s explore six ways to increase male infertility and optimise reproductive health. Maintain a healthy weight and diet. Maintaining a healthy weight and eating nutritious meals are important factors for boosting male fertility. Studies have shown that being overweight or underweight can negatively impact reproductive health. Being overweight or obese can reduce testosterone levels, sperm count, and sperm motility, making it harder to conceive. On the other hand, being underweight can cause hormonal imbalances and reduce sperm production. So, you may be wondering how to increase male fertility? One of the suggested ways to increase male fertility is to consume a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. These foods provide the necessary nutrients, vitamins, and minerals to support optimal reproductive health. For example, vitamin C and E, zinc, and folate are specific nutrients that can benefit male fertility. In contrast, processed foods, sugar, and saturated fats should be limited or avoided, as they can contribute to inflammation, hormonal imbalances, and obesity. Maintaining a healthy weight through diet and exercise can help regulate hormone levels and improve sperm quality, increasing the chances of conception. To achieve a healthy weight, men can focus on consuming fewer calories than they burn through physical activity. This can be done by reducing portions, choosing low-calorie snacks, and avoiding high-calorie beverages. It is important to note that crash dieting or extreme weight loss can also have a negative impact on male fertility. Therefore, it is essential to aim for gradual and sustainable weight loss by making long-term lifestyle changes. By maintaining a healthy weight and eating a balanced diet, men can take positive steps towards boosting their fertility and increasing their chances of starting a family. Exercise regularly but moderately. Exercise can significantly impact male fertility, but it’s essential to do it in moderation. Moderate physical activity can improve blood flow, hormone balance, and mood, enhancing fertility. When you exercise, your body releases endorphins, which can help to reduce stress and promote a sense of well-being. Additionally, regular exercise can lead to improved cardiovascular health, which can help to increase blood flow to the reproductive system. However, it’s important to note that excessive or intense exercise can have the opposite effect on male fertility. Overtraining can cause a decrease in testosterone levels, which can lead to reduced sperm production and quality. To maximise the benefits of exercise on male fertility, men should aim for at least 150 minutes of moderate exercise per week. It can include activities such as brisk walking, jogging, cycling, or swimming. Listening to your body and avoiding pushing yourself too hard is crucial. Knowing how to boost male fertility by finding the right balance between exercise and rest can help to improve the sperm’s overall health. Quit smoking and limit alcohol and caffeine intake. Smoking, in particular, is known to have several detrimental effects on male reproductive health. Not only can it damage sperm DNA, but it can also lead to a decrease in sperm motility and count. Research shows smokers have a lower average sperm count and lower sperm motility than non-smokers. In addition to these effects, smoking can also cause erectile dysfunction, which can further impact male fertility. If you’re a smoker looking on how to improve male fertility, quitting smoking is a crucial first step. Although quitting smoking can be challenging, especially if you try to quit all at once, it can help you quit for good. Gradually reducing your smoking can be an effective way to quit, as it can improve your sperm quality over time. By quitting smoking and making other lifestyle changes, such as limiting alcohol and caffeine intake, you can increase your chances of conception and optimise your reproductive health. It’s important to remember that even small changes can make a significant difference in improving male fertility. Limit alcohol and caffeine intake. Excessive alcohol consumption has been linked to several negative impacts on male fertility. Studies have found that men who consume more than five units of alcohol per week have lower sperm count and motility. Additionally, excessive alcohol intake can cause hormonal imbalances that negatively impact male fertility. These hormonal imbalances can lead to decreased sperm production and impaired sperm function. Knowing how to increase male fertility is crucial if you are trying to build a family with your partner. Limiting alcohol intake can improve sperm health and increase the chances of conception. Men should limit their alcohol intake to no more than two drinks per day. Reducing alcohol consumption can help improve sperm count, motility, and morphology, ultimately leading to an increased chance of conception. Moderate caffeine intake is generally believed to have no adverse effects on male fertility. However, excessive consumption of caffeine has been associated with reduced sperm motility and abnormal sperm morphology. According to a study published in the American Journal of Epidemiology, men who consume more than 300 mg of caffeine per day are more likely to have abnormal sperm morphology than those who consume less than 100 mg of caffeine daily. Reducing caffeine intake can improve sperm quality and enhance the likelihood of conception. It is recommended that men limit their caffeine intake to between 200 and 300 mg per day. Thus, understanding how to boost male fertility through limiting alcohol and caffeine intake can help to improve sperm health and increase the chances of pregnancy. It is crucial to remember that moderation is vital, and minor changes to lifestyle habits can significantly improve male reproductive health. Get adequate sleep Getting adequate sleep is

What is PCOS? If you or someone close to you has been diagnosed with Polycystic Ovary Syndrome (PCOS), you may be wondering what exactly it is and how it affects the body. Unfortunately, there are many misconceptions about PCOS that can make it difficult to understand this complex hormonal disorder. Debunking some of the most common myths about what is PCOS all about can help in understanding the condition better. Myth 1: All women with PCOS have ovarian cysts. One of the most common misconceptions about PCOS is that all women with this condition have ovarian cysts. It is not entirely true. While the name “polycystic” refers to the presence of multiple cysts on the ovaries, the truth is that not all women with PCOS have these cysts. The diagnosis of PCOS is based on combining clinical and laboratory findings. It is not just found through the presence of ovarian cysts. Typically, a diagnosis of PCOS is made when a woman presents with two of the following three criteria: irregular or absent periods, signs of high androgen levels (such as acne or excessive hair growth), and polycystic appearing ovaries on ultrasound. While the presence of ovarian cysts can contribute to the diagnosis of PCOS, they are not necessary. It’s also important to note that some women without PCOS can have ovarian cysts. It is common for women to develop ovarian cysts at some point in their lives, and most cysts are benign and resolve on their own without causing any problems. However, in some cases, ovarian cysts can become large or painful and may require medical attention. The truth is that PCOS is a complex hormonal disorder with various symptoms and contributing factors. While the presence of ovarian cysts is a characteristic feature of the condition, it’s not the only factor determining whether someone has PCOS. Other contributing factors may include insulin resistance, inflammation, and genetic predisposition. While it is commonly believed that all women with PCOS have ovarian cysts, this is a myth. Understanding the true nature of PCOS can help women receive proper diagnosis and treatment for this common hormonal disorder. Myth 2: Women with PCOS can’t get pregnant. It is a common myth that women with PCOS can’t get pregnant. Many women with PCOS may have heard or thought about the common question, “can you get pregnant with PCOS” It can be a source of concern and anxiety for many women. The truth is that while PCOS can affect fertility in some women, it does not mean that they can’t get pregnant. Many women with PCOS can conceive and have healthy pregnancies with the help of proper management and treatment. One of the primary factors that can affect fertility in women with PCOS is the irregularity of their menstrual cycles. In order to conceive, women typically need to ovulate regularly, which can be difficult for women with PCOS. However, there are a variety of treatments available that can help regulate ovulation and improve the chances of conceiving. For example, lifestyle changes such as maintaining a healthy weight and exercising regularly can help improve fertility in women with PCOS. Medications can also help stimulate ovulation and increase the chances of conceiving. In some cases, In-vitro fertilisation (IVF) may be necessary to achieve pregnancy.  It is essential for women with PCOS who are trying to conceive to work closely with their fertility specialist to develop a personalised treatment plan that addresses their specific needs and concerns. It may involve a combination of lifestyle changes, medications, and other interventions to optimise fertility and increase the chances of a successful pregnancy. While it is commonly believed that women with PCOS can’t get pregnant, this is a myth. With proper management and treatment, many women with PCOS are able to conceive and have healthy pregnancies. Myth 3: Women with PCOS are all overweight or obese. One of the most persistent myths surrounding PCOS is that all women with the condition are overweight or obese. It can lead to misconceptions about the condition and the stigmatisation of women with PCOS who do not fit this stereotype. The truth is that while weight gain and obesity are common in women with PCOS, not all women with this condition are overweight. PCOS can affect women of all shapes and sizes, and in fact, some women with PCOS may have difficulty gaining weight or may even be underweight. One of the reasons why weight gain and obesity are associated with PCOS is because the hormonal imbalances in women with the condition can affect how the body processes insulin. It can lead to insulin resistance, leading to weight gain and difficulty losing weight. However, not all women with PCOS experience insulin resistance; some may have normal insulin levels despite their diagnosis. In addition, PCOS can affect women’s metabolisms in different ways, contributing to weight gain or difficulty losing weight. For example, some women with PCOS may have a slower metabolism, while others may have a faster metabolism that makes it difficult for them to maintain weight. So how to lose weight with PCOS? It is vital to recognise what is PCOS and its complexity which can affect women in different ways. Weight gain is just one of many possible symptoms. Women with PCOS who are not overweight or obese may experience other symptoms such as irregular periods, acne, or excessive hair growth. Conversely, women who are overweight or obese may not necessarily have PCOS.  Myth 4: PCOS is a rare condition. In reality, PCOS is quite common, affecting up to 10% of women of reproductive age. It is one of the women’s most common hormonal disorders, yet it remains widely misunderstood and underdiagnosed. One of the reasons why PCOS is often thought of as rare is that it can be difficult to diagnose. Many women with PCOS may not experience all of the classic symptoms, or their symptoms may be mistaken for other conditions.  PCOS is a complex condition that can affect women differently, and its

Are you and your partner trying to conceive but struggling with fertility issues? Do not worry because you are not alone. Many couples face barriers when trying to conceive, but with advancements in technology, there are multiple ways to start a family. One of the most popular options is In-vitro Fertilisation (IVF), which is a procedure that has helped many couples achieve their dream of parenthood. However, it’s important to have a good understanding of the IVF procedure before deciding if it’s the right fertility treatment for you. Here are some commonly asked questions for couples considering IVF in Malaysia.    What is IVF? IVF is a medical procedure involving fertilising eggs outside the women’s body and transferring them back into the womb. The eggs will be surgically removed and placed in a laboratory dish. Then, the sperm from the male partner will be inserted into the egg for fertilisation. After a few days, the fertilised egg will be transferred back into the womb to achieve pregnancy.   How does IVF work? There are several medical procedures involved to help a couple overcome fertility problems. The entire procedure may take about 4 to 6 weeks.  Generally, the IVF procedure consists of the following: Ovarian stimulation – In this first step of IVF, a woman is given hormonal medication to stimulate the ovaries to produce multiple eggs. The medication would increase the chances of obtaining matured egg for fertilisation. The doctor will continue monitoring the woman’s hormone levels occasionally. Then, the doctor will perform ultrasound scans to track the growth and development of the eggs. Egg retrieval- Once the eggs have matured, they are surgically removed from the woman’s ovaries. Usually, the woman will be under general anaesthesia during this process. Then, a transvaginal ultrasound-guided needle is used to aspirate the fluid from the follicles that contain the eggs. The fluid will then be sent to the IVF lab. Sperm collection – The male partner is asked to provide a semen sample on the same day as the egg retrieval. The laboratory will then process it to obtain the healthiest and most motile sperm. Fertilisation – The retrieved eggs and the processed sperm are combined in a laboratory dish and placed in an incubator to allow fertilisation. The fertilisation process can take several hours, depending on the quality of the eggs and the sperm. Embryo transfer – The final IVF step involved transferring the selected embryos into the woman’s womb. It is usually done under ultrasound guidance, using a thin catheter to place the embryos into the womb through the cervix. The woman will then need to wait about two weeks to see if the embryos have been implanted. Successful implantation will result in pregnancy.   Who can undergo IVF? IVF is recommended for couples trying to conceive for more than six months or a year without success. It can also be suggested for couples with certain fertility problems like Endometriosis, Polycystic Ovary Syndrome (PCOS), damaged or blocked fallopian tubes, low sperm count and other severe fertility problems.   Is IVF painful? IVF is generally not considered a painful process. However, depending on person to person, it can be discomforting and painful. Some women may experience mild discomfort during the egg retrieval process, which can be typically managed through pain medication and general anaesthesia. After egg retrieval, they may experience side effects like headaches and mood swings. It is best to consult the doctor to help manage discomfort and ensure you are as comfortable as possible.     How successful is IVF in Malaysia? According to Malaysia Travel Healthcare Council, Malaysia recorded a 65% success rate for its IVF treatment in 2017, compared to the global average rate of 50%. It is important to note that IVF success rates can vary significantly depending on the clinic and each couple’s circumstances. Some clinics may have higher success rates due to their expertise, experience and use of advanced techniques and technologies. Thus, it is important to research and choose the clinic for a successful IVF.   How many cycles of IVF are needed to achieve pregnancy? The number of IVF cycles varies from person to person. Some couples may conceive after only one cycle, while others may require multiple cycles. For women under 35, the success rate of IVF is generally higher, and it is possible to achieve pregnancy within one to three cycles. However, for women over 35 years old, the chances may decline, and it may take several cycles of IVF to achieve a successful pregnancy. IVF can be emotionally and financially stressful, and some couples may choose to stop after several unsuccessful cycles. However, do not give up. Always consult and discuss your options and pregnancy chances with your fertility doctor.   What is the cost of IVF in Malaysia? IVF treatment costs differ according to the hospitals or clinics and the specific services required. On average, a single cycle of IVF can be around RM 14 000 to RM 25 000. Certain fertility problems may require additional medication or procedures, increasing the overall cost. It is best to consult the doctor to determine the best option for your fertility problem.   Are there any financial assistance available for couples facing financial problems? The Malaysian government provide an alternative to finance fertility treatment. Couples can now fund IVF treatment through withdrawal from their Employee Provided Fund (EPF). Legally married couples below 55 can now apply from their Account 2 savings for fertility treatments such as IVF, Intrauterine Insemination (IUI) and Intracytoplasmic Sperm Injection (ICSI). There is no limit as to how much a couple can withdraw. However, it is important for couples to clear their doubts regarding EPF before proceeding with financial aid.  Link: https://www.youtube.com/watch?v=msx5mrCQUa8&t=3s   Can IVF be combined with other treatments? IVF can be combined with other treatments to increase the chance of successful pregnancies. Some of the treatments include: ICSI – ICSI is a technique involving injecting a single sperm directly into the egg. This treatment is

Do you know when are you most fertile? Check out these top 10 questions about fertility and pregnancy timing. You have decided to start a family and embark on the exciting pregnancy journey. One of the most important aspects of this journey is to find out when are you most fertile so that you can try to conceive during that time. There is a duration called the fertile window when you are most fertile and has a high chance of getting pregnant. By understanding your fertile window, you can plan the right time to have sex and maximise the chances of conceiving. Here are some commonly asked questions about ovulation, fertile window, and fertility. 1. What is ovulation? Ovulation is when your body releases an egg from your ovary every month for fertilisation. It happens during the mid of your menstrual cycle and lasts only for a day. On an average, most women have their ovulation around the mid-cycle or the 14th day of a 28-days cycle. However, it can vary according to women. Some may ovulate earlier or later, depending on their cycle’s duration. 2. How can I determine when I am ovulating? There are a few ways to determine ovulation: –       Tracking the menstrual cycle One of the most common and easy ways to know your ovulation day is by tracking your menstrual cycle. Ovulation occurs in the middle of the cycle. If your menstruation cycle lasts 30 days, then the ovulation day may occur between the 14th to 16th day. –       Basal body temperature becomes high Basal body temperature is the temperature when your body is on complete rest. It increases when you are nearing ovulation. Typically, body temperature will be around 35.5 °C to 36.6 °C before ovulation. During ovulation, the temperature will be higher than usual. You may be nearing ovulation if your body is heaty some days after menstruating. It is best to keep track of your body temperature in the morning before you get out of bed. –       Cervical mucus changes to a wetter texture Cervical mucus is a fluid produced by the cervix. During the fertile window, the mucus becomes clearer, wetter, and stickier. It also has a raw egg-white texture which enables the intercourse to be smoother. 3. When are you most fertile? You are most fertile during your fertile window, which includes the days leading up to ovulation, the day of ovulation, and the day after ovulation. The fertile window lasts about 5-7 days for most women and occurs during the mid-cycle. If you have intimate relations during this time, your chances of getting pregnant are high. It’s important to remember that every woman’s cycle is different, and tracking ovulation can help you determine the timing of your fertile window. In addition, a fertility calculator or ovulation calculator can help you determine your fertile window, provided that your menstrual cycles are regular and ovulation occurs regularly. To use the calculator, you simply need to input the first day of your last menstrual cycle and your average cycle length, and it will estimate your fertile window. 4. Should I have sexual intercourse daily during my fertile window? It is not necessary to have intercourse every day during the fertile window. However, it is important to have intercourse regularly during the fertile window to increase the chances of conception. Typically, the fertile window is the six-day period that ends around the day of ovulation. The optimal time to have intercourse is in the days leading up to ovulation when you are most fertile. It is recommended to have intercourse every other day during this period to ensure that sperm is present when ovulation occurs. Ultimately, the decision of how often to have intercourse during the fertile window is up to you and your partner. Thus, always remember to maintain a healthy and supportive relationship, communicate openly about fertility goals and preferences, and seek medical advice if needed. 5. Does age affect my fertility? Age impacts fertility rate. Women are most fertile in their 20s and early 30s. However, the older you are, the less fertile you can be. Women have a lifetime supply of eggs in the ovaries. The average number of eggs you have during the first menstrual cycle is around 250 000 eggs. As your age increases, the number of eggs decreases. When you are 30 years old, the number of eggs will be less than 52 000. By 40, it drops even lower to around 9 000. Thus, it is best to get pregnant when your egg count facilitates pregnancy. You can opt for egg freezing earlier to get pregnant after your 30s. If you have been trying for more than six months without success, it is time to seek a doctor. 6. Can stress or lifestyle choices affect my fertility? Stress and certain lifestyle choices can impact your fertility. Chronic stress can disturb your menstrual cycle and affect ovulation, making it harder to conceive. Having constant stress can lead to shutting down the hypothalamic-pituitary-gonadal axis, a hormone-regulating mechanism that controls the reproductive system. It can disrupt the connection between your brain and ovaries, causing delays and absences in ovulation or irregular periods. Lifestyle choices like smoking, excessive alcohol consumption, unhealthy diet and irregular sleep cycles can also impact fertility negatively.  7. When are you least likely to get pregnant? You are least likely to get pregnant during your period. During period, you may have a low level of fertility. It is because no matured egg is released, making it harder to conceive. During menstruation, the unfertilised egg disintegrates and sheds with the uterus lining built for egg implantation. Another phase where getting pregnant is less probable is during the follicular phase or the first part of the menstrual cycle. This is because the ovary is getting ready to release an egg at this moment, and the cervical mucus is not conducive to sperm survival. The time between ovulation and menstruation,

How Much Is the IVF Treatment for Couples with Fertility issues?  For many couples, starting a family is a dream they hope will come true. Unfortunately, not everyone can conceive naturally. This is where I believe, In-vitro fertilisation (IVF) becomes a viable option. IVF has been around for many years and has helped millions of couples achieve their dreams to get pregnant and have a child. However, a common question that arises is “how much is the IVF treatment?”, but before getting into the details of the costing or price, I think it is important to first understand the essentials of the IVF treatment. What is IVF Treatment? In vitro fertilisation (IVF) is a fertility treatment that involves fertilising an egg with a sperm outside of the womb in a laboratory dish, after which the resulting embryo is transferred back into the womb. Typically, IVF is used when other methods of conception, like Intrauterine insemination (IUI), have failed. It is often considered the last resort for couples trying to conceive. The IVF procedure starts with the use of fertility drugs to stimulate the ovaries to produce multiple eggs, which are then harvested and fertilised with sperm in a laboratory. After fertilisation, the resulting embryos are monitored to track their development before being transferred into the womb, where they implant and develop into a healthy pregnancy. Who can benefit from IVF treatment? IVF is suggested for couples facing severe infertility problem. Some of the problems include: Fallopian tube blockage Fallopian tube blockage can prevent the sperm from reaching the egg, making it difficult to conceive naturally. IVF can bypass this fertility problem as it would not involve the fallopian tube during fertilisation. It works by retrieving the eggs from the ovaries and fertilising them with sperm in the lab. The resulting embryos can then be transferred to the uterus.  Polycystic ovary syndrome (PCOS) PCOS can make it difficult for women to ovulate regularly due to imbalance in hormone level. It may be caused by the increased level in testosterone, luteinising hormone (LH) or from having insulin resistance. These problems can make the conception more challenging. IVF can help by using medication to stimulate ovulation and retrieving the eggs for fertilisation in the lab. Endometriosis Endometriosis is a condition where the tissue that lines the uterus grows outside of it, sometimes in the fallopian tubes, and can cause pain and affect fertility. For couples with endometriosis, IVF can be an option because it bypasses the need for the sperm and egg to meet in the fallopian tubes, which may be affected by the condition.  Uterine fibroids Uterine fibroids are growths that can develop in the uterus and affect fertility. Depending on the size and location of the fibroids, they can interfere with the implantation of a fertilised egg. IVF can help by transferring the fertilised eggs directly into the uterus.  Problems in sperm production or function Men having problems with sperm production or function indicates fertility problems. The problem in sperm includes low sperm count, sperm with poor motility or abnormally sized sperm. If any of these problems are found during a sperm analysis, then IVF may be suggested. Alternative options for fertility treatment besides IVF. IVF is not the only option for couples struggling with fertility problems. There are other fertility treatments available that may be less invasive and costly. Before knowing how much is the IVF treatment, get to know the other alternative options that can also aid fertility problems. Some of the alternative treatments besides IVF include: –       Intrauterine Insemination (IUI) IUI involves placing washed sperm directly into the womb. IUI treatment begins with monitoring the woman’s natural menstrual cycle to determine the optimal time for the procedure. Sperm is then collected, washed and concentrated in the laboratory. The concentrated sperm is then inserted into the uterus lining using a thin catheter. This process increases the chances of the sperm reaching and fertilising the egg, resulting in a successful pregnancy. IUI treatment is often used in cases of unexplained infertility or when the male partner has a low sperm count or mobility. It is also suggested by doctors for women who have mild fertility problems such as mild endometriosis.  –       Intracytoplasmic Sperm Injection (ICSI) ICSI is a form of assisted reproductive technology (ART) that can be used to treat male infertility factors, such as low sperm count, poor sperm motility, or abnormal sperm shape. ICSI involves the injection of a single sperm directly into the cytoplasm of the egg using a specialized pipette, bypassing the natural barriers to fertilization. The fertilized egg, now called an embryo, is then cultured in a laboratory for a few days before being transferred into the woman’s uterus. ICSI has been shown to be an effective treatment option for couples experiencing male infertility factors, as well as for those with unexplained infertility or other fertility issues. How much is the IVF Treatment? The cost of undergoing IVF treatment can vary significantly and is influenced by several factors, including medical history and the clinic chosen to perform the procedure. In Malaysia, the average cost of a single cycle of IVF treatment ranges between RM 14,000 to RM 25,000, with some reputable clinics charging up to RM 25,000 per cycle. Additionally, medications or other procedures may incur additional fees depending on your specific fertility problem. Couples may require multiple treatment cycles before achieving a successful pregnancy, so it’s important to consult with a doctor and understand the personalized cost of treatment. Fortunately, financial assistance is available to those who may struggle to afford IVF treatment. I often advise my patients to explore government programs, insurance coverage, or financial assistance programs related to fertility treatments.  I believe that you can determine the best course of action to pursue your dream of starting a family.by gathering enough information and speaking with your doctor regarding your condition.  Financial Aid in Malaysia Many families do crowd-funding where grandparents, parents, siblings, aunts, uncles and

Where does fertilisation occur? All you need to know about fertilisation. You might be planning for a pregnancy or trying to understand how successful pregnancy happens. One of the fundamental keys to a successful pregnancy is knowing about fertilisation. Knowing where does fertilisation occurs and the importance of fertilisation can bring you one step closer to figuring out successful pregnancies. To understand the process, here are a few things you should know.   What is fertilisation? Fertilisation is when a sperm and an egg combine to form an embryo, which will develop into a baby after nine months. Fertilisation is a crucial step in pregnancy. Without fertilisation, you cannot get pregnant.   Where does fertilisation occur? Many people might misunderstand that fertilisation occurs in the uterus. However, it is not true. Fertilisation occurs in the fallopian tubes. After intercourse, the sperm from the ejaculate travels through the cervix into the vagina (womb). Then, it travels further through the fallopian tube to reach the eggs. The eggs are typically released from the ovary during ovulation. If one of the sperms manages to combine with the egg, it indicates that the fertilisation process is a success. After fertilisation, the combination of egg and sperm forms an embryo which will be implanted in the womb. If a couple has fertility problems, they may have trouble conceiving. Thus, they would have to undergo fertility treatments like IVF treatment. IVF treatment will have the egg and sperm fertilised outside of the uterus. It will be done in a laboratory on a petri dish. After fertilisation, the doctor will insert the fertilised egg or embryo into the womb to form a baby.    When does fertilisation happen? Fertilisation usually occurs during the time of ovulation. Ovulation is the process where a matured egg is released from the ovary. It will then travel through the fallopian tube, where it waits to be fertilised by the sperm. If fertilisation does not occur, the egg will shed along with the uterus lining through menstruation.   How fertility problems affect the chances of pregnancy Fertility problems can significantly impact a couple’s chances of getting pregnant. The effects of fertility problems can be devastating, and heartbreaking and may even cause emotional stress in relationships. Understanding how fertility problems can affect the chances of pregnancy is crucial for couples trying to start a family. Here are some of the issues that reduce the chances of conceiving: –          Blocks in the fallopian tube Knowing where does fertilisation occur will show you that the fallopian tube is an essential organ in the female reproductive system. When there is a problem in the fallopian tube, it indicates signs of fertility problems. Blocked fallopian tubes are a common problem faced by women with fertility issues. When the fallopian tube gets blocked, it restricts the passage for sperm to travel towards the egg. Thus, fertilisation does not occur. Doctors recommend fertility treatments like IVF to help with conceiving when the tubes are blocked. –          Endometriosis   Endometriosis is when the tissue that usually lines the inside of the uterus grows outside. The growth of the tissues can interfere with fertilisation by blocking or distorting the fallopian tube. It eventually affects their normal functioning, making it difficult for sperm to reach the egg. –          Polycystic Ovarian Syndrome (PCOS) PCOS is a hormonal disorder that can affect a woman’s chance to conceive. World Health Organization stated that around 116 million women suffer from PCOS. In PCOS, high insulin levels in the body can lead to an increase in androgen, a male hormone in women. It can cause changes in the ovaries and interfere with ovulation. The hormone imbalance can lead to the enlargement and development of cysts due to eggs not maturing and releasing as they should. It can lead to irregular or absent menstrual cycles and disrupt ovulation, making it difficult for a woman to get pregnant. Women with PCOS need proper treatment to balance their hormone levels and increase pregnancy chances. –          Male infertility Male infertility refers to the inability to contribute to conceiving a child. It can affect fertilisation negatively. For fertilisation to happen, the sperm’s health should be in good condition. A healthy sperm count should be at least 15 million and above, and the sperm should have good motility and shape. If the sperm’s health is below average, then it may not be able to penetrate the egg and fertilise it. –          Unknown reason It is a situation where the regular fertility test cannot detect the cause of infertility. Even though it is difficult to figure out, it can be caused by conditions and factors like age-related infertility, ovulation problem, and many more. These conditions can impact the ability of the egg and sperm to meet and fertilise, resulting in difficulties in conceiving. It is essential to consult a doctor earlier to check the fertility status.   What are the differences between natural fertilisation and fertilisation through treatments? Natural fertilisation is when sperm and egg fertilise naturally in the fallopian tube without medication intervention. When sexual intercourse happens, sperm are deposited into the vagina. It then passes through the uterus towards the fallopian tube, where it encounters the egg released from the ovary. Fertilisation through treatments refers to medical procedures that assist the fertilisation process. However, where does fertilisation occur with medical intervention? That can vary depending on the procedure. There are different types of fertility treatments: –          In Vitro Fertilisation (IVF) It is the most well-known form of fertilisation treatment. Eggs are collected from the ovaries and fertilised with sperm in a laboratory dish. Upon fertilisation, the embryo will be transferred to the womb. IVF may be suggested for endometriosis, PCOS and more. –          Intracytoplasmic Sperm Injection (ICSI)  ICSI involves injecting a single sperm directly into an egg. ICSI is suggested when the sperm has

What Is IUI Treatment? Here Are 6 Things You Should Know Before Considering the Treatment There are many couples out there who dream of holding their babies. While some couples are lucky enough to have a smooth pregnancy, there are others who may struggle to conceive. If getting pregnant seems to be a problem, do not worry. With today’s technology in the medical field, there are multiple ways you can get pregnant despite your fertility problem.  Intrauterine Insemination (IUI) is a type of fertility treatment where sperm is placed directly into the womb. It is a common treatment for couples having fertility problems planning to conceive. If you are trying to understand what is IUI treatment, here are six things you should know before considering the treatment   IUI treatment is less painful. IUI treatment, in general, is less painful. It uses less invasive tools than other fertility treatments like In-vitro fertilisation (IVF) or Intracytoplasmic sperm injection (ICSI). Doctors use a catheter, which is a flexible tool, to place the sperm into the womb. Some women might feel slight discomfort or cramping during the insertion, but the pain usually subsides within hours. If you experience pain for a prolonged period, you may call your doctor to get checked.      You can opt for IUI treatment if you have mild fertility problems. IUI treatment is usually recommended if couples have mild fertility problems. Mild problems may include the following: Low sperm quality A healthy sperm quality depends on healthy sperm count, motility, and shape. According to World Health Organization, a healthy sperm count should be around 15 million per millilitre (ml) or at least 39 million per ejaculation. Good sperm motility means at least 40% of sperm should swim forward with no problem. A sperm count within 10 to 15 million sperm per millimetre shows mild oligospermia; Sperm motility below 40% suggests low sperm motility. Doctors may recommend IUI treatment if the female counterpart has no fertility issues. However, it is best to consult the doctor so they can advise the best option for the fertility problem. Mild endometriosis Endometriosis is a condition where the endometrium tissues grow outside the uterus. These growths are known as endometrial implants. Usually, these tissues build and shed every month during menstruation. However, the tissues that grow outside of the uterus cannot be shed, thus, gets trapped. These trapped tissues then form scarring and cysts. Mild endometriosis is a condition that includes a few small implants and scarred tissues in the reproductive organs. Doctors may suggest undergoing a few rounds of IUI treatment for this condition. However, if the endometriosis is severe, you may be requested to take other fertility treatments like IVF. Cervical issues The cervical issue can also reduce the chances of pregnancy. If sperm cannot pass through the cervix, it may not reach the egg and fertilisation may not happen. Additionally, if the cervical mucus is thick and sticky, it can slow the sperm or even block the sperm from reaching the egg. IUI treatments allow the sperm to skip the process as sperm is directly placed in the uterus. Unexplained fertility It is a condition whereby a standard fertility test cannot detect the cause of a couple’s fertility problem. You and your partner may have a healthy uterus, good sperm count and egg count but still unable to get pregnant. In this case, doctors may suggest IUI treatment to help couples get pregnant.    IUI procedure is less complicated. The duration of a complete IUI cycle can vary depending on your fertility problem. If only one counterpart has fertility problems, the process may end quickly. However, if a couple has fertility issues combined, it may take slightly longer to get pregnant. It may require more time, but the process is less complicated. Here is the step-by-step process for any IUI treatment so you can understand what is IUI treatment all about and what to expect during the procedure. Step 1: Consultation with a doctor Generally, a couple will start the IUI journey by consultation with a doctor before the procedure. The doctor may require the medical history of a couple. They may proceed with a blood test, a semen sample, an ultrasound scan and other relevant tests to determine the cause of the fertility problem. Step 2: Ovarian stimulation Depending on the problems, the doctor may give fertility medications or injections to stimulate the ovaries. It helps to increase the number of eggs released during ovulation. Step 3: Monitoring and ultrasound While taking medications, the doctor may ask to visit a few times to monitor the ovaries and the development of eggs. It ensures that the progress is going smoothly without complications in the development. Step 4: Ovulation induction Once the eggs mature, the doctor may give a ‘trigger’ shot to stimulate ovulation. It shortens the time of ovulation. These four steps can be skipped if the inability to get pregnant is due to male infertility. Step 5: Sperm preparation On the day of the procedure, the male counterpart will provide a semen sample. It is then washed to remove immobile sperm, debris, seminal fluid and other substances resulting in a highly concentrated sperm. This step is done to avoid any irritation in the uterus, and it also increases the chances of pregnancy. Step 6: Insemination During insemination, the doctor will use a catheter to insert the highly concentrated sperm into the uterus. There may be slight discomfort during the insertion, but it is entirely normal. The process takes only a few minutes to complete. Some women may be required to undergo a second insemination depending on their fertility problem. Step 7: Pregnancy test After the procedure, progesterone tablet will be prescribed. It is a hormone that prepares the uterine lining for a possible pregnancy. You may visit the doctor after three weeks of the procedure, to check whether or not you are pregnant. Alternatively, you can also check at home using the pregnancy kit.   IUI may not be

What is Body Mass Index (BMI) and how does it affect your ability to get pregnant? (BMI Malaysia) Body Mass Index or BMI is a measurement or tool used to estimate your body fat. It is calculated based on your height and weight. BMI is often measured to determine if you are underweight, normal weight, overweight, or obese. However, do note that BMI does not accurately measure your body fat but only provides the estimated percentage of the body fat. The calculation is done by dividing your weight in kilograms (kg) by the square of heights in meters (m2). Alternatively, you can also use a BMI calculator, where you have to key in your weight and height to get the results. After getting the results, you can check your measurements in the standard weight categories. According to the BMI Malaysia chart, the measurement for normal BMI is 18.6 – 25.0. If your BMI measurement is below 18.5, then it is considered underweight. If it is around 25.1 – 30.0, it is categorised as overweight. Meanwhile, you are considered to be obese If the numbers show 30.1 or higher. It is no secret that weight problems may impact your fertility. If you are in the category of overweight or obese, do not lose hope as pregnancy is very much possible despite the fertility issues that you may face. It is advisable to consult a fertility doctor if you have trouble getting pregnant within six months of trying. The fertility team will then help you to plan your journey to achieve your dreams to be parents. I have been consulting and helping many patients who had overweight issues to get pregnant over the years. Thus, I believe with proper fertility treatment plans and a weight loss strategy, you have a brighter chance to conceive and welcome a bundle of joy in your life this year. What is The Ideal BMI To Get Pregnant? A healthy weight with a normal BMI helps to lessen the time and health complications so that you can have a smooth delivery and a healthy baby. If your BMI is high or low, you can still get pregnant. However, it is risky and may reduce the chances of conceiving. Being overweight or having a high BMI is often associated with other medical conditions such as diabetes, high blood pressure, cardiovascular diseases, and more. It can independently affect fertility too. Hence, some women may need to treat these health conditions before undergoing fertility treatments. You are advised to always consult your doctor before opting for treatments. How does the weight problem affect fertility in women? Weight problems can affect your fertility in several ways. Being overweight or obese can disrupt the hormone balance and may cause difficulties to ovulate. Additionally, it also increases the risk of infertility-related conditions such as polycystic ovary syndrome (PCOS) and endometrial hyperplasia. Being underweight can also cause problems in ovulation. Hence, it is commonly advised to maintain a normal BMI when you are planning to get pregnant.      How does weight problem affect male fertility? Being overweight or obese can affect male fertility in several ways. Excess weight may lead to decreased testosterone level and causes sperm count to be low. Some researches have shown that men with a higher body fat percentage tend to have lower sperm counts, and lower sperm motility. These conditions can make it difficult for the couple to conceive naturally. Additionally, weight gain may increase the risk of metabolic disorders such as diabetes that can lead to infertility issues. Obesity may also decrease libido and cause erectile dysfunction in men. Thus, it is important for men to maintain a healthy weight to preserve their fertility. Can Maternal Obesity Cause Adverse Pregnancy Outcomes? (High BMI & Malaysia Overweight Rate) Maternal obesity refers to a woman being overweight or obese during pregnancy. Obesity or overweight problems, in general, is a growing concern in Malaysia. According to statistics from the National Health and Morbidity Survey (NHMS) conducted by the Ministry of Health (MOH) Malaysia, the prevalence of obesity among women of reproductive age increased from 15.1% in 1996 to 22.8% in 2015.  Being overweight or obese can lead to a number of complications for both the mother and the baby if the pregnancy is not well-monitored. Pregnant women with a high BMI can suffer from pregnancy complications like miscarriages, stillbirth, and gestational diabetes. Furthermore, maternal obesity can increase the risk of health problems for the baby such as having a higher risk of getting congenital disorders, growth problems, childhood obesity, or type 2 diabetes.  Getting good pregnancy care such as regular monitoring of weight changes and practicing a healthy lifestyle helps to lessen pregnancy complications. Thus, do not worry if you are currently obese or have a high BMI while pregnant. Always consult your doctor and follow their advice carefully so that you can lead a healthy pregnancy journey.   Is it possible for an obese woman with PCOS to get pregnant?  Yes, it is possible. However, your pregnancy journey may be quite difficult. Polycystic Ovary Syndrome or PCOS is a common condition that affects menstruation and ovulation which leads to difficulty in conceiving. While it is possible for overweight women with PCOS to get pregnant naturally, many of them require additional help to ease their fertility journey. Thus, it is best to consult a fertility specialist and discuss viable options once you are ready to start a family. Having good fertility care and a personalized treatment plan based on your health conditions increases the chances of healthy pregnancy.   What Are the Available Fertility Treatment Options for Couples with High BMI?  Several fertility treatment options can be considered by couples facing overweight or obesity problems to help them conceive. Some of the treatment options are ovulation induction, Intrauterine Insemination (IUI), and In-Vitro Fertilization (IVF). The doctor may also suggest men with obesity or overweight problems opt for Intracytoplasmic Sperm Injection (ICSI) treatment to increase the fertility treatment’s success rate. Thus, do not

What is IVF Treatment and how it helps couples with infertility issues conceive? Many couples facing infertility issues might have heard about fertility treatments such as IUI and IVF. But many are still wondering about what is IVF treatment and how exactly this treatment can help them to get pregnant. In Vitro Fertilization commonly known as IVF or test tube baby is a type of assisted reproductive technology that fertilises an egg with sperm outside the body in a laboratory dish. Upon fertilisation, the embryo will be transferred to the woman’s womb to help her achieve a successful pregnancy. Getting IVF treatment can be an emotional roller coaster ride for many couples with fertility issues. Thus, the couple needs to understand the process and procedures involved in the treatment so that they can be physically and mentally prepared to undergo the treatment.   Getting to know the 6 Basic Steps of IVF Treatment Step 1: Consultation and Fertility Assessment Typically, the journey to IVF starts with consultation and fertility assessment with a fertility specialist. During the consultation, the fertility specialist will conduct a review of the couple’s medical history and ask them to undergo a physical examination and fertility assessment. The assessments may include pelvic and abdominal ultrasound scans, semen analysis, and blood tests. These assessments are done to check the overall health and find the potential cause of the couple’s inability to conceive. After reviewing the results of the medical assessment, the doctor may suggest the couple to opt for IVF treatment depending on the severity of the fertility problem. During the consultation, the couples are encouraged to ask as many relatable questions as possible to understand their condition better. Step 2: Ovarian Stimulation The next step in an IVF cycle is to stimulate the ovaries to allow multiple eggs to mature. This process is done by taking daily injections of hormones in certain dosages as instructed by the doctor. The hormonal injections typically start on the 2nd day of the woman’s menstrual cycle. It will be taken continuously for five days. After the 5th day, the doctor will do an ultrasound scan to check the growth of the eggs. Subsequently, the doctor will continue the injections for another five days, making a total of 10 days of injections. Then, the doctor will do another ultrasound scan to check the best time to retrieve the eggs. The retrieval process will only happen when the eggs reach 17mm and above. Step 3: Egg Retrieval Once the eggs are matured, the egg retrieval process will be done. The patient will be given a form of anaesthetic that helps her to relax and be pain-free during the procedure. The matured eggs are retrieved using a transvaginal ultrasound. A long thin needle is inserted through the vagina and guided to the ovaries using ultrasound imaging. Then, the eggs are removed from the ovarian follicles and placed in a dish containing a special solution. The dish is then put in an incubator before proceeding to the next steps. The egg retrieval process usually takes about 10 – 15 minutes. After the egg retrieval, some patients may experience mild cramping, bloating, bleeding, or spotting. These side effects should resolve within a few days. It is advisable to talk to the fertility doctor if the effects are severe. Step 4: Fertilisation On the same day of egg retrieval, the male partner will have to give a sperm sample. After getting the sample, the embryologist will proceed to choose the best egg and sperm and fertilise it in the lab. The first step of fertilization process involves insemination. It is the process of combining the egg and sperm in a petri dish which will then be placed in an incubator to form an embryo. Step 5: Embryo transfer This step is done once the embryo is formed and ready to be implanted in the uterus. Before the embryo transfer, the woman will be given medications to prepare the uterus lining. The embryos are then placed into a thin catheter, inserted through the cervix, and into the uterus. The embryos are gently pushed out of the catheter and into the uterus. The entire procedure is commonly done without using any sedation. After the embryo transfer, the patient will be advised to rest for a few hours and to avoid strenuous activity for the next few days. What to do after the Embryo Transfer? Typically, there is a two-week waiting period before taking the pregnancy test. This time can be emotionally and physically challenging for many couples. Understanding what is IVF treatment and procedures helps to keep the couple remain calm and mentally prepared to face the result. Here are a few things that the couples may be advised to do after the embryo transfer: Take a good rest Getting IVF treatment is a potentially life-changing procedure, so it is better to relax and take it easy for the next couple of days. After the transfer, the patient will be advised to rest well and reduce strenuous physical activity. They will be encouraged to priorities self-care and do enjoyable things that do not involve vigorous movements such as watching movies or reading. It is important for them to pamper themselves and keep their mind relaxed and calm during the waiting period.   Continue the medications Doctors may prescribe progesterone tablets or pessaries, or even injections. The patient should continue these medications at the appropriate time. It helps with the embryo implantation process. Although, it isn’t very pleasant to take these medications but hang in there for this may help to ensure a successful pregnancy. Eat healthily It is important to stay healthy during this time. Practice healthy eating habits and continue taking the multivitamins and folic acid prescribed by the doctor. Getting more information about what is IVF treatment, prenatal care and diet is vital to a healthy pregnancy journey and can make a big difference.  Be in a Supportive Environment It is advised for the patient to