In modern times, 1 out of 8 couples impacted by infertility. This percentage is set to increase notably in cities, more so in couples wherein, both the partners are working professionals.
Here Dr Tan Chee Hoe, O&G from Pantai Hospital Cheras sharing his insights on how the modern lifestyle affect fertility in recent years and tips on optimizing fertility.
What is infertility?
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Infertility is defined as not being able to conceive after trying for more than 12 months (6 months for women more than 35 years old), without any contraceptive precautions.
Is infertility a common problem in Malaysia?
Infertility is not something new. According to the World Health Organization, about 1 in 8 couples has a problem trying to conceive and having a baby.
The increase in infertility cases in recent years is likely due to increasing awareness of infertility complications and changes in contemporary lifestyles.
Is infertility just a woman’s problem?
Infertility has traditionally been thought of as a woman’s problem. But as it turns out, men are not spared from the causes of infertility.
In fact, men contribute to more than 40% of the causes of infertility. Women contribute to another 40% while the remaining 20% is due to unexplained causes.
In view of this, it is crucial to get the husband involved during fertility screening and treatment in order for the fertility doctor to provide you with a holistic treatment plan.
What causes infertility in men?
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The leading causes of male infertility are urogenital disease, sexual dysfunction, sexually transmitted disease (STD), obstructed spermatic cords, testicular mumps infection, testicular failure, undescended testis and varicocele.
Others include hormonal problem, genetic abnormality, chemotherapy and local radiotherapy due to cancer.
Recent global data in semen analysis revealed that there is an increase in sperm abnormalities and sperm count is in a reducing trend.
Contributing factors for these findings include an increase in paternal age, unhealthy lifestyle (smoking, E-cigarettes, alcohol consumption, sedentary lifestyle, recreational drug use & steroid use etc.), processed food, obesity, plastics and chemical toxins, pesticide, herbicides, pollution etc.
How does the modern lifestyle affect fertility? What are the factors that contribute to infertility?
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Fertility decline as we age. It is best to start trying sooner than later. Unfortunately, a contemporary trend sees not only women opting to delay starting a family, men too are postponing fatherhood.
In today’s rat race society, many are engrossed in chasing career opportunities and financial stability. Furthermore, we see a change in lifestyle and an increased search for freedom. Occasionally, some are still waiting for their Mr and Mrs Right to appear.
At birth, women are born with a fixed number of oocyte (eggs) inside their ovaries for their entire life. The decrease in fertility with female ageing is mainly due to the decline in quantity and quality of eggs.
A substantial number of eggs are lost before puberty and at every menstrual cycle. The progressive loss of eggs is a normal process, and the loss of eggs is accelerated after 35.
Women will be attaining menopause when the reserved oocytes (eggs) inside the ovaries are depleted, marking the end of the reproductive period.
Women younger than 30 have around a 20% chance of getting pregnant each month, and the chance declined to 5% per month when the women reached the age of 40.
The consequences of advancing maternal age are relevant to the risk of natural and medical assisted conception and the outcome of pregnancy.
Due to the ageing process, the quality of eggs is affected. There is an increased risk of genetic abnormalities called aneuploidy.
Aneuploidy refers to an abnormal number of chromosomes in the fertilized egg, resulting in the condition such as Down Syndrome.
Thus, as women age, they become less likely to conceive easily, more likely to have miscarriages and a higher risk of having children born with a chromosomal problem. Not to mention complications associated with pregnancy in ageing mothers.
Fibroids, endometriosis, endometrial polyps and ovarian cysts are acquired gynaecological diseases, which are more common when women age and in women who have not given birth before. These diseases might affect your chance to conceive in future.
Semen analysis in mature men often show a lower sperm count and lower quality. Hence, mature men take longer to impregnate their female partner and fathering a child than younger men.
Besides, there is an increased risk of miscarriage, autism, abnormal genetic inheritance (i.e., Down Syndrome).
Why does stress cause infertility?
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Human has an excellent adaptive mechanism for stress. Stress could disrupt fertility, but it rarely causes infertility. Women can continue to bear children during war, famines and other extreme situations.
Is there any new treatment available to treat infertility in men and women?
Non-Invasive Chromosome Screening (NICS) is a type of Preimplantation Genetic Testing (PGT) during In Vitro Fertilization (IVF), especially if genetic testing is required.
NICS can diagnose embryos with genetic abnormality before the embryo is transferred back to the uterus for implantation.
Therefore, it increases the chance of IVF success and produces a genetically healthy baby.
The principle of NICS is based on sequencing the genomic DNA secreted into the culture medium from the embryos, hence avoiding the need for embryo biopsy which causes potential injury to the embryos. Traditionally, embryo biopsy is needed for preimplantation.
Genetic Testing is not required when NICS is applied.
What are the complications one might face from the treatment?
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Infertility treatment is very safe. Complications from IVF includes Ovarian Hyperstimulation and IVF procedure-related complications, which are seldom encountered nowadays.
Perhaps, treatment failure is more of a concern than the complication itself.
Examples: Poor treatment outcome due to the ageing process, poor eggs & sperm quality, and poor embryo quality as well as underlying gynaecological health problem etc, are the most common causes of fertility treatment failure.
What are the prevention tips that may help optimize fertility?
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Women and men should maintain a healthy lifestyle before they start trying for a baby.
Being in optimal weight, not smoking, limiting alcohol intake, exercising regularly, and optimizing pre-existing medical problems are essential in increasing pregnancy chances.
It is vital for your baby’s health if you have a successful pregnancy.
A healthy lifestyle is important; it includes consuming more fresh fruits and vegetables and having a regular good sleep rhythm.
Others include supplementing yourself with nutritious food, multivitamins, and essential nutrients (Folate, Vit D, Calcium, nutrient and good fat). It is found to be beneficial and can give your fertility a boost.
Nevertheless, regular fertility and gynaecological health screening are of utmost importance.
Early diagnosis and prompt treatment of a gynaecological disease may help to preserve your fertility function for future parenthood journey.
Source: This article is written by Dr Tan Chee Hoe, Obstetrics & Gynaecology (O&G) of Pantai Hospital Cheras (PHC)
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Baca juga: 9 Signs of infertility in men and women all couples should know
