Get Dr Christopher Ng's opinions on your questions! Only approved questions are displayed.
Vaginal douching may potentially wash away the viable sperm that is still in the upper vagina and this may reduce the chances of conception.
On the other hand, some patients may develop vaginal infections after intercourse if they do not douche after intercourse.
It is best to wash approximately 20 minutes after intercourse to reduce the risk of developing vaginal infections after intercourse but yet give enough time for the viable sperm to swim into the cervical canal for conception.
PID is a serious gynaecological condition that can potentially cause permanent damage to the Fallopian tubes and therefore infertility.
This is more likely to occur if there are pelvic abscesses around the tubes which have not been surgically drained, and inappropriately treated with effective antibiotics.
It is getting increasingly more popular for women to undergo some sort of pre-pregnancy tests first before they conceive.
This is to determine if there are any possible issues that need to be addressed first before getting pregnant (eg. rubella vaccination).
The basic tests include:
A physical examination is also performed to determine your height, weight, BMI (body mass index) and blood pressure is measured (to exclude pre-existing high blood pressure).
Being on Diane 35 for 4 years should not delay your overall ability to conceive because once you stop taking oral contraceptive pills, your fertility should return.
The ability to conceive would then be determined by a variety of factors (your age, ability to ovulate, the patency of your Fallopian tubes and your partner's sperm quality).
Progesterone is an important hormone that can effect your ability to conceive and also your ability to maintain a healthy pregnancy.
The role of progesterone when trying to get pregnant is to thicken the endometrium (uterine lining) to a desired thickness which is essential for implantation of the embryo in the uterus (womb) and therefore to achieve a successful pregnancy.
Low progesterone levels can potentially cause irregular menses which can then affect the timing of your intercourse. Progesterone levels are usually low in the early part of your menstrual cycle and tends to rise after you have ovulated (release of the egg from your ovary into the Fallopian tube during your fertile period).
If your progesterone levels remain low after your fertile period, this may indicate that you have not ovulated and therefore you may experience some difficulty in getting pregnant in addition to having irregular menstrual cycles.
Once you are pregnant, progesterone is needed to maintain the endometrial thickness and to support your pregnancy so much so that low progesterone levels are associated with abnormal vaginal spotting / bleeding during early pregnancy and also increase risk of miscarriage.
According to the Centre for Disease Control (CDC), and the World Health Organisation (WHO), the only 2 vaccines that are recommended for pregnant women are the whooping cough (Pertussis) vaccine and the flu vaccine as these 2 infections can have serious effects on newborn babies.
Whooping cough is an infection that leads to upper respiratory tract like symptoms in an infected adult (cough, low grade fever).
In newborn babies however, besides the upper respiratory tract symptoms, it can cause the airways to acutely swell and narrow leading to airway obstruction. This is a medical emergency and requires immediate treatment and hospitalisation.
Because of the rising incidence of whooping cough in newborn babies, it is now recommended that all pregnant women receive the whooping cough vaccination between 27 to 36 weeks of pregnancy.
Flu is a common infection that affects both pregnant and non-pregnant women and in most cases it is mild. Pregnancy can lead to changes in a mother's immune system so much so that pregnant women may be more susceptible to these infections.
The reason for recommending flu vaccination to pregnant women is that it can potentially be associated with preterm labour and the infection may affect the baby.
The flu vaccine can be given at any trimester and is especially recommended during the flu season depending on which part of the world you live in.
You will be happy to know that there are now Non-Invasive Prenatal Tests (NIPT) available which can screen for not only sex chromosome abnormalities but also for Down syndrome and other genetic disorders caused by extra or missing chromosomes in the baby's DNA.
The more well known ones available are Harmony and Panorama Tests. During pregnancy, some fetal DNA crosses into the mother's bloodstream and a simple blood test performed on the mother from 9 weeks onward is able to screen for any evidence of these chromosomal abnormalities. The results will be back in about 10 to 14 days.
The sensitivity, specificity and negative predictive values for these tests are generally very good. Remember that these are still screening tests so if you are found to be at high risk for one of the sex chromosome abnormalities, then a diagnostic invasive test in the form of amniocentesis or chorionic villus sampling (CVS) can be offered to confirm the diagnosis.
As a result of hormonal changes during your menstrual cycle, your vaginal discharge can vary in its appearance and nature accordingly. During the pre-ovulatory phase of the cycle, the oestrogen levels are low and the discharge is thick and sticky.
This forms a mucus plug which blocks the cervical canal and can potentially make it hostile to sperm. Once your fertile period approaches with the rise in oestrogen levels, the discharge becomes wet and slippery like egg white.
As ovulation occurs, the discharge is then more fluid and thinner which helps protect sperm from acidic secretions in the vagina and keeps sperm alive to aid sperm migration into the uterus. Following ovulation, the discharge again becomes thick and sticky preventing sperm entry into the uterus. your vaginal discharge therefore helps your chances of conceiving during your fertile period.
This is the variation in vaginal discharge during your normal menstrual cycle. A yellow sticky discharge therefore may not be physiological ("normal") so it is best to have this checked out to exclude vaginal infections which may possibly damage your Fallopian tubes and therefore your chances of getting pregnant.
This is a rather controversial topic as there are some conflicting evidence to suggest that it does while others show no evidence as such.
Having said that, looking at the general overall consensus, the general feeling among gynaecologists is that it is not possible to say with any confidence whether endometrial scratching can increase the probability of pregnancy for natural intercourse or IUI (intrauterine insemination).
As for endometrial scratching in IVF, there is some evidence to suggest that endometrial scratching performed between day 7 of the previous cycle and day 7 of the embryo transfer (ET) cycle is associated with an improvement in pregnancy rates in women with more than two previous embryo transfers.
There is no evidence of an effect on miscarriage, multiple pregnancy or bleeding. The procedure is associated with some mild discomfort.
The best advice we can give is for your sister to avoid all forms of alcohol (beer, wine etc) during her entire pregnancy to be absolutely safe.
There is no safe time or "safe" amount of alcohol that she can consume during pregnancy because alcohol in the mother’s blood passes to the baby through the umbilical cord.
Besides causing fetal alcohol syndrome, alcohol during pregnancy can also lead to miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities.
Different people have different levels of pain thresholds. Some women are able to go through natural childbirth without asking for any form of pain relief. The majority of women however will ask for something to relieve their discomfort.
Entonox (laughing gas) is a colourless, odourless gas made up of half oxygen and half nitrous oxide. It is the mildest form of "pain relief". It has a rapid onset and is safe for you and your baby. 
If entonox doesn't do the trick then there is the option of pethidine injections. The intramuscular pethidine injection is administered into your thigh or buttock and takes 20 mins to work. The analgesic effect lasts for up to 4 hours so it is usually not recommended if you are close to delivering as its effects (side effects include nausea, vomiting, drowsiness) may pass over to the baby and the baby may become drowsy after birth.
Finally there is the epidural which involves infiltration of local anaesthesia via a thin tube into the epidural space in the lumbar region. This procedure is performed by an anaesthetist. Its advantage is that it takes 10-15 minutes to offer complete pain relief and the analgesic effects can be topped up so it is very good for long labours and can be used for instrumental deliveries and emergency Cesarean sections if natural birth is not possible in the end. Epidurals can cause a slight drop in maternal blood pressure and the fetal heart rate will need to continuously monitored during labour.
There are other alternative non-medical forms of pain relief like acupuncture, aromatherapy, homeopathy, hypnobirthing, massage and reflexology. They may work for some patients, but for the majority of women, most of these techniques may not provide effective pain relief and it is best that you discuss this with your gynaecologist before you go into labour.
Exercising and staying healthy can improve your background chances of fertility. Having said that though, if you overdo it to the point that you start missing your menses then this could indicate that you are not ovulating regularly spontaneously and this would then reduce your chances of conceiving. Too much of a good thing is not helpful.
Moderation is best. You should check that you are ovulating spontaneously during your fertile days. If you are ovulating regularly then it is fine to continue with your strenuous physical exercises.
If you are not ovulating, then you should stop the exercises or cut down and see your gynaecologist as soon as possible who should be able to give you ovulation medication and to exclude other causes of infertility.
I am a 34 years old female. I had a missed miscarriage and a chemical pregnancy over the last 2 years. Are there any tests that you might suggest, as I am not sure if I can handle a third loss.
I am exploring treatment options as I have been trying for a child for over 2 years with no success. Will IVF or IUI be the best treatment in terms of success for my situation?
I would like to find out if the morning after pill (Plan B) can harm one's fertility?
I’m 26 years old. My recent ultra sound scan showed that there are more than 12 immature follicles in my right ovary. What does this mean, and how does it affect my fertility and ability to get pregnant?
For a lady with Turner syndrome, is there any way to have a baby?
I am 28 years old and trying to conceive. I have previously had a few yeast Candida infections, and I am afraid that it will affect my chances of getting pregnant.
I am trying to conceive. What are the best sources of folic acid? Do supplements work well, or do I have to take tablets? For example, I have a bottle of Thorne Research Basic B Complex that contains folate as one of the ingredients.
I am wondering how autoimmune disease can affect a pregnancy.
My IVF was unsuccessful. On Day 5 of transfer, the embryos did not reach the blastocyst stage. I was told that this is due to an egg quality issue. How can we improve egg quality and embryo development?
I'm 33 and have fertility issues due to PCOS. I've failed IVF once. I've never had regular periods, in spite of medication. I am currently still trying to conceive.
Is there a prenatal test for autism? Are there any tests that can help to determine the risks for autism before the baby is born?
I'm 7 months postpartum and still breastfeeding. I haven't gotten my period yet. Thank you.
I previously had unprotected sex. Recently, I had worse than usual period cramps and one extremely painful cramp led to expulsion of tissue the size of a 20c coin. Could this be due to a miscarriage of a pregnancy that I was not aware of? Are there any ways to tell the difference between a heavy period or a miscarriage?
I just delivered my baby one month ago by C-section. I was wondering what normal recovery is like after a C-section - for example, is there anything in particular I should watch out for during the recovery period? Thank you!