Early aid for infertility

06 May 2014| last updated at 08:39PM

ANNE (not her real name) was in her 20s when she married. She had wanted to have a baby as soon as possible to complete her family. However, after eight years of trying, she still could not conceive.

 When Anne consulted a gynaecologist, it was found that she was suffering from an ovulation problem. Her ovaries could not consistently release eggs. She was given medication to regulate the hormone that will help resolve her problem and a year after the treatment, she was pregnant and now has a year-old girl.

 Sabah Care Specialist Centre fertility specialist Dr Cheong Yee Tsing says Anne did not seek treatment earlier as she did not think she or her husband had infertility issues since both are young. Although most of her patients are professionals, she says awareness level is still low.

 “Even when they are exposed to information on the issue, they are unsure how to deal with it, who and where to find experts and this delays treatment. In dealing with conception, we are racing against biological issues,” she says.

 “The sooner a couple sees a specialist and finds the cause of failure to conceive, the higher the chances of reversing the condition. It is a worrying trend as one in six couples in the country are at risk of infertility. If this continues, it will eventually affect the country’s economy as the number of elderly will be more than productive young adults. The only way to overcome this is for couples to start a family within two years of marriage.”

DEFINING INFERTILITY

World Health Organization (WHO) defines infertility as a disease of the reproductive system by the failure to achieve a clinical pregnancy after a year or more of regular unprotected sexual intercourse.

Infertility is categorised into primary and secondary. Primary is when a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth. Meanwhile, secondary infertility happens when a woman cannot get pregnant after the first pregnancy regardless of the outcome.

 The reproductive age for women is between 15 and 49 while for men, the sperm count and quality decline as they age. Male infertility accounts for 30 per cent of infertility cases and the same goes for women.

Another 30 per cent of the cases cannot be explained while 10 per cent are due to both female and male issues.

The common causes of female infertility include inability to release eggs, tubal blockage, over or underweight and advanced maternal age.

 Dr Cheong pointed out that male infertility was on the rise from exposure to glue, silicone, pesticides or chemicals.

“Radiation emitted from mobile phones and other gadgets can also damage or impair sperm quality. Therefore, it is advisable for the public to keep gadgets away from the body,” she said. Smokers of both genders are 60 per cent more likely to be infertile than non-smokers.

MEDICATION AND SURGERY

She said women who face hormonal problem can be treated with medication while surgery is needed for blocked or damaged tubes. Endometriosis requires laparoscopic surgery to remove the tissue growth.

 As for men, infertility may also be due to sperm quality and quantity, anatomic abnormalities or damaged reproductive organs, as well as blockages which may require surgery.

 She says intrauterine insemination (IUI) is usually used as a first-line treatment in which clean sperm is inserted using a catheter into the uterus during ovulation. Another method is in-vitro fertilisation (IVF) which involves fertilisation of eggs and sperm in the laboratory.

“The success rate of fertilisation with IUI is 15 per cent and IVF 30 per cent, both are higher than conceiving manually which is only about three per cent. Of course, couples have to understand that sometimes the treatment works after several cycles,” she said.

 However, she said not all infertility problems can be treated such as women who are without eggs (ovum), or have unhealthy eggs. It also applies to men with poor sperm quality.

 The cost of IUI is between RM1,000 to RM2,000 per cycle whereas IVF is between RM10,000 and RM20,000. Couples in Sabah who go for IVF at a government hospital can only do it at Likas Women and Children’s Hospital.

Dr Cheong explaining one of the treatments for infertility.