When you and your spouse make the decision to try to conceive (TTC), it comes with a fair amount of uncertainty ― especially if one of you has a health condition that could impact your ability to have a baby.
Gleneagles Hospital consultant ob-gyn and SmartParents expert, Dr Christopher Chong explains that doing a preconception consultation before trying for a baby can allay your fears.
When your gynae conducts preconception tests, they will identify any medical conditions or problems they will need to rectify, Dr Chong notes. Your doctor will also be assessing your family history for any hereditary diseases.
Doing preconception tests will also ensure that you don’t waste time over unsuccessful attempts, energy, or lose the motivation to keep trying.
Tests include a pelvic ultrasound to detect abnormal growths such as fibroids and ovarian cysts. A Pap smear will also be done to assess your cervical health. Dr Chong lists the three most common causes of female infertility:
WHAT This condition causes the tissue on your uterus lining — called endometrium — to grow outside the uterus. Even though these tissues are displaced from the womb, it continues to function as it normally would, which means that it will thicken, break down and bleed every menstrual cycle. Tissues from the diseased area are usually surgically removed to ensure an accurate diagnosis. Dr Chong estimates that endometriosis accounts for about 20 per cent of all cases of infertility in Singapore.
WARNING SIGNS Pelvic pain and cramps may begin before your period and last several days into your period. Some sufferers also report experiencing lower back and abdominal pain, along with excessive bleeding, during periods. Feeling pain during intercourse, bowel movements and urination are also symptoms of endometriosis.
TREATMENT If your doctor detects any growths in your uterus and if you’re experiencing any painful symptoms, surgery will have to be carried out to treat the issue. After surgery, injections and medication will be given to disrupt your menstrual patterns while your body heals.
Polycystic Ovarian Syndrome (PCOS)
WHAT? Dr Chong explains that PCOS is a commonly under-diagnosed hormonal disorder which disrupts your ovaries’ normal functions. “Many do not seek treatment and often see the doctor only when they experience irregular menses or fertility issues.” PCOS isn’t a permanent disorder, either. Some patients see their periods spontaneously return to normal, especially obese individuals whose menstrual problems go away after losing weight healthily. This condition is usually diagnosed with an ovarian scan or through blood tests.
WARNING SIGNS Infrequent, irregular or prolonged menstrual cycles are the most common symptoms. For instance, some may experience fewer than nine periods a year or go for more than a month without having their period. As PCOS is a hormonal problem, sufferers also have elevated levels of male hormones — androgens — in their bodies, which gives rise to excessive facial and body hair and severe acne.
TREATMENT Pills — such as Clomiphene — can be given to regulate menses and induce ovulation. Your doctor may also dispense Metfromin, which can aid weight loss, which is believed to help boost ovulation. Another treatment option — called “golf-balling of the ovary” — requires holes to be drilled into the thick layer of tissue covering your ovaries. Dr Chong notes that it is this thick layer of tissue that compromises your body’s ability to ovulate. “Drilling holes in the wall of the ovaries is believed to [create other openings for the eggs to be released [into your tubes].” Unlike endometriosis, you can continue to try to conceive while receiving treatment for your condition.
“Many do not seek treatment and often see the doctor only when they experience irregular menses or fertility issues.”
WHAT? When you have your period, an egg is released from the ovaries and travels down one of the fallopian tubes into the uterus. Tubal infertility occurs when your fallopian tubes are damaged, scarred or obstructed, which blocks the egg from travelling to the womb. Dr Chong says some of the causes of tubal infertility include:
* Pelvic infection or pelvic inflammatory disease.
* Sexually transmitted diseases (STD).
* Damage to the tubes as a result of prior surgery.
* Previous ectopic pregnancy.
* Cysts or fibroids forming in the walls of the tube.
WARNING SIGNS Most times, patients with tubal infertility do not experience any symptoms, apart from their inability to conceive. However, if it’s due to an STD ― and depending on the type of infection ― you may experience pain during and after urination or have some vaginal discharge.
TREATMENT Dr Chong states, “The only way is to undergo surgery ― including microsurgery ― to treat any damage or scarring to your tubes.” You will also need to wait at least three months after your surgery before trying to conceive again. If you don’t observe this rule, it will increase your risk of an ectopic pregnancy (when your pregnancy occurs outside the womb, such as your fallopian tubes.
Women’s problems are only a third of all fertility issues…
A couple who is infertile can attribute one-third to female issues, the other third to male problems, while for the remaining one-third is because of both male and female complications ― the causes may even be unknown. So, treating a woman’s fertility problems is only resolving a third of your fertility problems as a couple. Besides making sure your man gets tests for common male infertility problems, it’s vital to seek help as soon as possible. Delay treatment and you’ll only be putting your chances of conceiving at risk!
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