According to the definition of the World Health Organization, infertility refers to "failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse".
8-12% of couples of reproductive age around the world suffer from infertility. Likewise, fertility also declines with age.
While there are many reasons that contribute to infertility, some diseases, such as endometriosis, pelvic inflammatory disease, anovulation disorder or menstrual irregularity could increase the chance of infertility. Psychological problems have been shown to contribute the problem, that some studies have shown that stress, anxiety, and depression are associated to infertility.
In addition, male factors include asthenospermia (weakness in sperm), oligospermia (low sperm count) or azoospermia (no sperm count), stress are contributing factors of infertility.
Hence, couples who fail to conceive naturally within 12 months are recommended to seek advice from medical specialists in order to address the problem of infertility.
A comprehensive fertility assessment includes couple's personal medical history and sexual life pattern. Both parties will then be arranged to undergo relevant medical examination, which include:
- Pelvic ultrasound
An ultrasound probe is used to examine the uterus and ovaries, check for presence of fibroids in the uterus, ovarian cysts, adenomyosis, or endometrial polyps, etc., which could be the causes that affect the implantation of fertilized eggs and thus reduce the chance of pregnancy.
- Hysterosalpingogram (HSG)
This is an imaging which assess if there is presence of blockage of fallopian tubes and where the collusion occurs. The test also evaluates whether the uterus has any congenital abnormalities, polyps or fibroid inside uterine cavity, etc. The imaging procedure shall be performed around the 5th to 10th day of the menstrual period, with abstinence practiced since the day 1 of the menstrual period in order to avoid pregnancy before examination. Follow-up measures have to be taken as soon as possible should obstruction or abnormalities be found in the uterus.
- Ovarian function assessment
The function of the ovaries is critical to treatment efficacy. Before performing any assisted reproduction treatment [e.g. In vitro fertilization (IVF) treatment], doctors will assess the patients’ ovarian reserve in order to estimate the response of the ovaries to the ovulation induction drugs during treatment. These assessment includes:
- Blood test for follicle stimulating hormone (FSH)
- Blood test for anti-mullerian hormone (AMH)
- Vaginal ultrasound in monitoring antral follicle counts (AFC)
- Semen analysis
Seminal analysis covers the areas of sperm count, morphology and motility of the sperm. Before you save your sperm for analysis, we advise you to
- Avoid ejaculation for 2-3 days
- Avoid drinking alcohol for 2-5 days
- Avoid hormonal medication
Should abnormalities be found after the examination, the medical specialists will recommend appropriate plans to improve the success rate of pregnancy.