“Infertility is defined as an inability to conceive a child after one year of trying if you’re below 35 years old and after six months of trying if you’re above 35 for a female,” said Dr Jasdev Singh, 39, a fertility specialist.
Fertility, he added, is based on a woman’s age because the quality and quantity of her eggs decline considerably as she ages. “While a male’s fertility also declines with age, the impact is generally less significant as sperm can be replenished.”
Common fertility issues among females, he shared, include ovulation disorders. This can lead to irregular bleeding caused by hormonal imbalances and stress, among others.
“Another common issue is polycystic ovary syndrome or PCOS. The causes are hormonal imbalance, insulin resistance and excessive weight gain,” said Jasdev. Signs and symptoms include irregular bleeding, acne and excessive hair growth on the face and hands.
Endometriosis, a condition when tissue similar to the lining of the uterus grows outside of the uterus, is another issue. While causes are unknown, it is believed that hormonal factors and immune system dysfunction cause it. Signs and symptoms include painful periods and heavy bleeding.
Other fertility issues include blocked fallopian tubes and uterine fibroids, which are growths in the uterus.
For males, common infertility issues include low sperm count and poor sperm quality, both caused by hormone imbalances, infections, smoking and excessive alcohol consumption. The signs and symptoms are a decreased libido and reduced ejaculate volume. There can even be no symptoms at times.
Another condition is azoospermia, where there is no sperm in the ejaculate. Among its causes are hormonal imbalances, past infections, blockage in the reproductive tract, genetic conditions and trauma to the testis area.
Treatment options
According to Jasdev, general treatment options for both sexes include weight management, adequate intake of nutrients and vitamins, and reducing stress.
Specific treatment options include:
- Females: assisted reproductive technology such as Intrauterine Insemination (IUI), where sperm is injected directly into the uterus or In Vitro Fertilisation (IVF), where eggs are fertilised with sperm in a laboratory and transferred to the uterus.
- Males: surgical sperm retrieval or hormonal therapy for those with azoospermia.
Myths and misconceptions
“A common myth is that only women are responsible for infertility. Honestly, male infertility is actually on the rise now, and 40-50% of infertility is caused by males.”
Infertility, he emphasised, is not a sign of personal or moral failure. “Infertility is a medical condition. It’s not a reflection of your morality. I think it’s very important. Don’t blame yourself.”
Another misconception is that PCOS, which leads to excessive weight gain, facial hair and acne, is solely a cosmetic condition. “It can cause heart diseases, diabetes mellitus and endometrial cancer.”
Some assume that all PCOS patients are overweight, although Jasdev revealed that he has treated thin women too.
There is also a misconception that IVF is painful and invasive. However, Jasdev said that many women find the experience manageable. “Another myth is that IVF babies are more prone to health complications. There are no studies supporting this claim.”
Some also believe that IVF provides a 100% guaranteed solution to infertility. “It doesn’t. But for females, the younger you are, your success is much higher.”
Additionally, early awareness can help a person better understand their health. “If you’re aware that you have a medical condition such as PCOS, endometriosis, a blocked fallopian tube or azoospermia, you can address it much earlier.”
By identifying fertility challenges early, couples can make informed family planning decisions such as exploring treatment options or considering alternative plans.
“If you know that you have a family history of fertility issues, underlying cyst, fibroids or endometriosis, go for fertility assessments early,” he said, adding that the recommended age is when you’re in your mid-20s to 30s.
Assessment methods include an ultrasound to assess ovaries, uterus and fallopian tubes, and semen analysis for males.
“In conjunction with World Fertility Day, the message I would like to share is: start your fertility assessment and journey early because we know age matters. The younger and earlier you start your treatment, the better the success. And never give up.”