What is Infertility?
Infertility is defined as not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant due to miscarriages may also be defined as being infertile. Around 10-15% of women have infertility issues.
- Primary infertility (someone who has never conceived or given birth before)
- Secondary infertility (someone who cannot get pregnant despite having had previous child or children)
What causes infertility?
- Age (changes of getting pregnant decreases with age especially after the age of 35 because of the gradual reduction of eggs as the woman gets older)
- Unhealthy lifestyle (smoking, overweight, lack of exercise or stress)
- Medical issues (previous cancer treatment, hormone issues such as thyroid or diabetes)
- Polycystic Ovary Syndrome (PCOS)
- Primary Ovarian Insufficiency (POI)
- Blocked Fallopian Tubes (such as scarring from previous surgery or pelvic inflammatory disease)
- Endometriosis
- Uterus issues (such as fibroids or adenomyosis)
- Poor sperm production
Click to watch Demystifying Medicine video on Reasons for Infertility
What Tests will be done on the husband and wife?
1. Semen analysis for the partner. This is best performed 3-5 days after abstinence to check on the number, the motility (movement) and morphology (shape) of the sperm.
2. Ultrasound scan to check for uterus (womb) and ovary abnormalities. It can also be used to measure the ovarian reserve known as the Antral Follicle Count
3. Hysterosalpingogram (HSG) to check the anatomy and patency of the Fallopian tubes and uterus is usually performed after your menses
4. Hysteroscopy to look into the uterus anatomy
5. Laparoscopy to check for diseases of the ovaries and for endometriosis
6. Blood tests to check whether the hormones (such as anti-Mullerian hormone, thyroid, prolactin or sex hormones) are normal. Blood test for women may be taken around day 2 to 4 of menses.
Pre-Implantation Genetic Testing (PGT)
PGT can be considered as genetic profiling of embryos prior to implantation. It is used to screen for genetic diseases so that there is a higher chance of successful pregnancy and the baby will be free of inherited diseases
- PGT-A (determines the correct number of chromosomes in the embryo to reduce the risk of unhealthy embryos such as Down’s syndrome and increase the success of pregnancy)
- PGT-M (determines whether embryo has inherited diseases such as Thalassemia or Cystic Fibrosis)
- PGT-HLA (determines whether the embryo’s HLA matches or is compatible with it’s siblings)
- PGT-SR (determines the Structural Rearrangement to see if the embryos are healthy)
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