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MESSAGES TO
Fertility (IVF & IUI)

Fertility (IVF & IUI)

A DxD Session with Dr Fong Yang


Ended on Sun Jul 21 2019
Ended

Top Answers


Thanks for the D2D. A fertility assessment would start with a detailed history of both you and your partner/spouse. This would serve to shed light on your general health, existing medical problems (if any), and issues specific to your chances of conception.

A physical examination would follow, and for ladies an ultrasound scan of your pelvic organs (ie. womb and ovaries) is essential. This would then enable the doctor to tailor investigations specific to your condition.

For example, if you have irregular menses, the scan may show small cysts in the ovaries and a blood test for certain hormones will help us to diagnose conditions like polycystic ovaries.

For men, a semen analysis would give preliminary information on the quality and quantity of sperm, from which further tests or treatment can be formulated.

These initial checks would form a basis from which treatment plans can be discussed and implemented.

21 Sep 2018

Thanks for the D2D. IVF is one end of a spectrum of fertility treatment options, and it is usually used when all other methods have not worked.

There are simpler means of conceiving, from ultrasound scans to tracking egg development and timing of ovulation, pills to enhance the chances of egg growth, and techniques like intra-uterine insemination (IUI) to improve the odds of sperm-egg fertilisation. These methods do not, or hardly involve the use of injections.

 If IVF does become necessary, we can always teach your husband to administer the injections for you. Many ladies are actually surprised at how easy and painless these injections are. In fact, the type of needles/ injection pens used are similar to those used by diabetic children.

If a young child can self-administer insulin injections, I am sure most ladies can learn too, after a 1-on-1 tutorial from the clinic! Good luck!

21 Sep 2018

Hi Wen Hui, 

Thanks for the D2D. If you have decided on doing IVF, then the most important thing is not to delay or procrastinate any further. Consult your fertility doctor as soon as possible, and bring all available medical records and/or medication with you during your first consultation.

If you have existing medical problems, eg. thyroid, diabetes, SLE etc, please consult your respective specialists at the same time to have these conditions controlled. When you speak to your fertility doctor, it would be useful to discuss with him any treatment plans that your medical specialists may have.

If necessary, your fertility doctor can speak to and discuss your medical issues with your other specialists.

No two people have exactly the same set of issues, and through discussions between medical specialists, we can tailor a program that suits you best. This will ensure better outcomes for you.

21 Sep 2018

Thanks for the D2D. Stress is inevitable in modern society, and especially so in a place like Singapore. We know from research that prolonged or chronic stress is bad for health, be it fertility or mental health or even general well-being.

We have to acknowledge that it is impossible to eliminate stress completely, but by learning to manage it or reducing the level of stress, the impact on health may be quite remarkable.

In the field of subfertility, stress is known to affect menstrual cycles, cause ovulation irregularities and occasionally egg quality too. This is very clearly seen in ladies with polycystic ovaries, or in those with anovulation (difficulty in producing eggs regularly), where certain periods of stress may lead to delayed menses or altered menstrual flow and volume.

Examples of these include delayed menses during stressful exams, trying to meet month-end sales targets or after a tiring and hectic overseas trip.

In short, stress does affect fertility but the effects can be reduced or overcome through life-style changes and techniques to cope with stress. Medical therapy can also help in the meantime to improve your chances of conception while you are coping with stress, hence you may wish to try both methods concurrently.

21 Sep 2018

Thanks for the D2D. This really depends on the reason why you had to do IVF in the first instance.

If IVF was done because you felt it was the fastest way to have a baby, or if you failed to conceive naturally even though no obvious cause was found, then the next pregnancy may be easier naturally, or with some basic medical help (e.g. Ultrasound scan to assist with tracking of egg growth and timing of ovulation).

If IVF was done because your fallopian tubes were blocked, or the was a significant problem with sperm count/quality, then you may have to consider IVF again the 2nd time round.

21 Sep 2018

Hi Jia Yun, 

Thanks for the D2D. Most fertility doctors in Singapore are very well trained, so you will be in good hands.

You may want to meet with the doctors and discuss your issues. That way you can also have a feel of each doctor’s approach to your needs; it is important that you are comfortable with whoever you decide to seek treatment with, and that you develop a good rapport with him.

If you can work well with your doctor, you are more likely to comply with treatment protocols, and that will go a long way to help you achieve that pregnancy you have been longing for!

21 Sep 2018

Hi, thanks for the D2D.

Both methods can be effective, but a lot depends on your medical condition and the causes of your subfertility in the first place. 

IUI is relatively simple, less invasive, less costly and less time-consuming, but the success rates are lower. Certain existing conditions make IUI less favourable, for example if your husband’s sperm count and quality are low, or if you have 1 or both fallopian tubes blocked.

IVF gives you the best chance of getting pregnant, but it demands more of your time and effort, is more invasive and costly, and most ladies find it more stressful.

You and your spouse should discuss this issue with your fertility doctor in order to understand and select the type of treatment that best suits you.

31 Oct 2018

Hi,

Clots during your menstrual period suggest that your menstrual flow is heavy, which allows for blood to pool in the uterus and form clots.
 
These clots are then expelled, usually with the help of uterine contractions, and are commonly associated with menstrual cramps.
 
For most ladies, clots have been a part of their menses since their teenage years; for these ladies there is usually nothing to be worried about.
 
However if your menses is normally clot-free, but you have started experiencing clots in the last few months, then this is a symptom to be investigated further.
 
These clots may be due to a plethora of reasons, some of which may include fibroids, polyps, endometriosis or hormonal imbalances.
 
If you have been trying to conceive for the last 6 to 12 months without success, then it would be wise to see a gynaecologist to have this issue looked into.
5 Dec 2018

Top Questions


I had been trying to conceive for 6 months. I had a fertility test screening that showed my Progesterone test result was was on the lower end of the normal range, according to the phase in my cycle that I took the test. 

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 had mild OHSS after the 10th day of embryo transfer. The bloating is causing me signficant discomfort, such that I need to lie down on bed literally the whole day. How can I treat the symptoms of a late onset of OHSS after pregnancy?