Doctor’s answers to fertility treatment options
We asked Dr Suresh Nair, Consultant Obstetrician & Gynecologist, what fertility treatments options are available, the option with the highest success rate and how to avoid using medical measures to conceive.
The fertility treatment options available are as follows:
(i) One of several fertility treatment options is stimulating the growth of eggs from the ovary by using either tablets or injections. An example of a well established tablet which is a fertility medication is Serophene (Clomiphene). In cases which need more stimulation or when tablets don’t work, then fertility injections are required.
A well known example is Gonal F; this is a hormone injection which is similar to the natural hormone, Follicular Stimulating Hormone (FSH).
(ii) Another fertility treatment option is either using natural cycle or the above two ways to stimulate eggs and combining it with the introduction of processed sperm from the husband into the womb which is done in the clinic. This is called intra-uterine insemination or IUI.
(iii) The most efficient and advanced method is assisted reproductive technology or commonly known as IVF. Here higher doses of Gonal F (FSH) are given for about 10 days and thereafter ripening the eggs with an injection called Ovidrel.
The eggs are then ready to be sucked out using a very tiny needle guided by ultrasound through the vagina. This procedure is done under light anaesthesia and does not require a hospital stay.
These eggs are sucked out from the follicles and sperms are injected into them in the laboratory and it is grown from 3 to 5 days to create the very early conceptus or baby called the “embryo”. The best ones are then put back into the uterus from 2 to 5 days after the eggs were taken out.
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Here are some ways for couples to avoid fertility treatment options all together but maintain a healthy lifestyle and conceive naturally. Check out some of the suggestions given by Dr Suresh Nair.
The single most important thing a couple can do to increase their chances for pregnancy is to have babies when they are young. The age-related decline in fertility is more important for women. This is because a woman’s egg quality and egg count drops from age 24 years and significantly from age 35 years. The statistics of this is as follows:
The peak of a woman’s fertility is between 20 to 25 years. From 25 to 30 years, it drops between 4 to 8%. From 30 to 35 years, it drops 15 to 19%. From 35 to 40 years, it drops 26 to 46%. From 40 to 45 years, it drops 95%!
Two other important things a couple should do is to maintain a good body weight, avoiding obesity or being very underweight, and the other is to stop smoking which is very detrimental to fertility.
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Other measures include avoiding contracting sexually transmitted diseases and practising safe sex and should one contract STD, to promptly treat it with the appropriate antibiotics. This is because STD can damage the reproductive organs.
Abuse of drugs and alcoholism also make a major impact on fertility. Avoidance of pollutants in our food and water is very hard to do but eating healthy food prepared in the right way is very important in maintaining one’s fertility.
For men, it is important not to wear tight underwear or take frequent long hot baths and also not to put the laptop on one’s lap as the heat can affect the testes and sperm production.
Regular moderate exercise is good but excessive exercise can also diminish fertility potential in men and women.
It is also important to have appropriate vaccinations to avoid illnesses that can damage the reproductive system. Also, using protective masks in a high risk environment and living healthy can avoid sicknesses such as tuberculosis and hopefully mumps so that one’s fertility does not get affected because these diseases can cause a lot of damage to the reproductive organs and can diminish one’s fertility.
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Dr. Suresh Nair is a senior consultant obstetrician and gynaecologist currently in group private practice in the Gynecology Consultant’s Clinic and Surgery at Mount Elizabeth Medical Centre.
He is also currently the Medical Director of the Parkway Fertility Centre, the assisted reproductive centre situated in Mount Elizabeth Hospital where about 500 fresh cycles are done per year.
He is also a Visiting Consultant to the National University Hospital, KK Women’s and Children’s Hospital and Changi General Hospital. He had held the post as President of the Obstetrical and Gynaecological Society of Singapore from March 2009 to March 2011.
He has been invited as faculty to lecture and conduct training programmes in assisted reproduction and endoscopic surgery at regional and international meetings, and has contributed to peer-reviewed journals and written chapters in several authoritative books.
He has been a keen teacher and mentor to gynaecologists in Singapore and the region. He derives great joy and fulfilment in proctoring and guiding those who wish to improve their clinical skills but is ever willing to learn from both his senior and junior colleagues.