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Assisted conception
What are the causes of infertility?
 
Causes of infertility can be broadly divided to male factor only (35%), female factor only (35%) or combined (20%).  In 10% of couples, no causes can be identified (unexplained).

Female factors

  • lack of ovulation (egg production) due to advanced age, excessive weight loss or polycystic ovaries
  • endometriosis i.e. abnormal old menstrual blood in the areas behind the womb or within the ovaries
  • blocked fallopian tubes due to infections
  • distortion of the womb due to congenital abnormalities or fibroids

Male factors

  • No sperm production due to failure of the testicles or obstruction of the connecting ducts
  • Poor sperm quality due to varicocele (dilated veins in the testis leading to overheating), inherited causes, smoking
  • Sexual difficulties e.g. erectile dysfunction  or in ability to ejaculate
   
What is the general advice to couples trying for a baby?
 
 
Both partners should lead a healthy lifestyle, reduce stress levels, consume a healthy diet and avoid toxins such as smoking, excessive alcohol or caffeine.
It is important to seek help early if there is a suspicion of problems such trying without success for more than a year, history of surgery to the reproductive organs or women who are attempting a pregnancy at a more advanced age (more than 37 years). The couple should undergo thorough investigations such as semen analysis, pelvic ultrasound, hormonal blood tests or if necessary diagnostic keyhole surgery to look at the internal female organs (laparoscopic surgery).
   
What is the treatment for infertility?
 
Treatment depends on the causes of infertility.
  • If there is a lack of egg production, doctors would use ovulation induction medications
  • If sperm quality is poor or have difficulties with intercourse, the couple should try artificial insemination (IUI)
  • If there are presence of cysts or endometriosis or unfavourably situated fibroids, the woman may need surgery
  • Finally, if the tubes are blocked beyond repair or the sperm is profoundly poor, the couple may need Assisted Reproductive Techniques (ART) or test tube baby treatment such as Invitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI).
   
Why do some women miscarry?
 
Early miscarriages (less than 12 weeks) are likely to be due to an abnormal baby (70%).The risk is greater if the woman is older. Women exposed to certain infections like rubella, or some occupational chemicals may also miscarry. Miscarriages may also be due to a condition called Antiphospholipid Syndrome where the body produces antibodies that fights against the placenta. Women with Polycystic ovaries may have abnormally high hormone called Luteinizing Hormone (LH) which affects egg development leading to a higher chance of miscarriage.
   
What are the statistics of infertility in Malaysia?
 
There is unfortunately no official data but as in most countries, about 1 in 10 couples have some form of fertility problems. Recent estimates put the figures as about 350,000 couples in Malaysia.
   
Are revolutionary methods such as test tube babies (IVF) available in Malaysia?
 
There are now about 40 IVF centres in Malaysia offering a variety of ART (test tube babies) treatment.  Treatment is getting more popular as current lifestyle and delay in child bearing increases the risk of being infertile. Also, infertility is no longer considered a social stigma; more couples come forward for treatment. But treatment is generally limited to the middle class population because treatment is costly. An average IVF cycle cost anything between RM 12 to 18,000 per cycle.
   
Disclaimer
 
For Patients:
The health information provided in this website is not intended as a substitute for medical advice, diagnosis, or treatment.  Always consult your own physician for your own specific medical condition.

For Health Professionals:
While efforts has been made to get the relevant experts in each topic to contribute, the views and opinions of authors expressed in this section do not necessarily reflect those of the OGSM.

   
     
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