Infertility

Am I infertile?

Infertility refers to difficulty conceiving despite regular sexual intercourse without using birth control. 80 out of 100 couples conceive within a year of trying, and 92 out of 100 within 2 years of trying. 

Although there is no definite cut off, the general recommendation is that if you are younger than 35 years old and have been trying for a year, or if you are 35 years and older and have been trying for 6 months – it is time to seek help from a gynaecologist. 

If you know that you have certain risk factors that can result in you having a higher chance of having fertility issues, you should seek help earlier. Infertility treatment are common in Singapore.  

What are the common causes of infertility in Singapore?

There are many causes of infertility. Despite investigations, however, the cause for 1 in 4 couples’ infertility may still end up being unknown. Some of the more common ones include:

Female

• Age: this is the single largest determinant of fertility; the older you are, the sharper the decline in fertility
• Polycystic ovary syndrome (PCOS)
• Body mass index (BMI) too low or too high
• Intense exercise 
• Medical issues e.g. diabetes, kidney disease etc 
• Premature ovarian insufficiency (previously known as premature menopause)
• Endometriosis
• Pelvic inflammatory disease: may cause scarring, hydrosalpinx etc 
• Uterine fibroids: in certain locations 
• Endometrial polyps

Male

• Undescended testes
• Testicular tumours 
• Current or previous infections e.g. sexually transmitted infections (STIs), mumps
• Varicocele
• Previous surgeries e.g. to testes, inguinal hernia repair etc
• Genetic conditions that affect sperm development e.g. Klinefelter’s syndrome 
• Medications, previous chemotherapy, steroids for bodybuilding
• Lifestyle factors: being overweight, smoking

What tests do I need?

Your gynaecologist will take a detailed medical history from you and your partner. A pelvic examination will be performed. These tests may be recommended:

Female

• Ultrasound scan: to check for uterus and ovarian abnormalities
• Vaginal swabs: to check for sexually transmitted infections (STIs)
• Blood tests: to check your ovarian reserve, blood count, thalassemia, communicable diseases e.g. Hepatitis B/syphilis/HIV, immunity to chickenpox/rubella (to see if you require pre-pregnancy vaccinations)
• Hysterosalpingogram: check the patency of your fallopian tubes 
• Pap smear/HPV test: if it is not up-to-date

Male

• Semen analysis: to check for sperm count, motility and morphology

Which infertility treatment in Singapore are more suitable?

It depends on the cause. 

As a broad overview, there are varying degrees of assisted reproductive techniques:

• Timed sex according to ovulation
• Ovulation induction and timed sex 
• Artificial insemination (Intrauterine insemination, or IUI)
• In-vitro fertilisation (IVF)

Depending on the results of your investigations, your gynaecologist will discuss the infertility treatment options that are suitable for you.