Why getting pregnant is so hard

When you are trying for a baby, many issues could derail your chances. We take a look at them.


Infertility in Singapore is on the rise, say both fertility doctors SP spoke to. One in seven couples here suffer from infertility, notes gynaecologist and fertility specialist Dr Kelly Loi, who runs The Health and Fertility Centre for Women. Approximately one-third of the issues involving fertility are due to women, one-third to men, and the remaining one-third complications from both partners or from unknown causes.

If couples are below 35 years, they are usually encouraged to seek medical help after failing to conceive for a year, and after six months if they are older. However, Dr Roland Chieng, an obstetrics and gynaecologist specialist at Roland Chieng Fertility and Women Care, urges his clients to give it at least two years.

“At the end of one year, about 85 per cent of couples will conceive as long as they are having regular intercourse, and this number shoots up to 90 per cent by the end of two years,” he explains. “At the end of the two years, the incidence doesn’t go up anymore.”

However, you should consult your doctor early if you have a pre-existing condition, such as irregular menses or pelvic problems, that could thwart your chances of getting pregnant.

1. Age matters

In Singapore, a major contributing factor to infertility is that both men and women are delaying marriage and parenthood plans. Dr Loi notes, “The average age that women are delivering their first baby has risen to 30 years old.”

While it may seem like a decent age to have a baby, a woman in her late 20s has only about a 20 per cent chance of conceiving every month. This figure plunges to 8 per cent if she’s in her late 30s. “Plus, there’s also an increased risk of miscarriage with increasing age,” Dr Loi points out.

Although a man’s fertility isn’t impacted until he’s well into his 50s, the quality and quantity of his sperm may deteriorate over time, so that it’s difficult for the sperm to reach the egg and fertilise it. The good news is that a man can improve his sperm quality by following a healthy diet and lifestyle and taking antioxidant supplements.

Abdominal surgery, appendicitis or a ruptured appendicitis, as well as ruptured cysts can damage the tubes, preventing the sperm from fertilising the egg.

2. Hormonal imbalances

According to Dr Chieng, age-related problems aside, hormonal imbalances in women are a major cause of infertility. Some 90 per cent of the time, this is caused by polycystic ovary syndrome or PCOS, a genetic condition characterised by a failure to ovulate, which leads to weight gain and missed or irregular periods.

Dr Chieng notes that this condition can be treated easily if the woman changes her lifestyle, such as by losing weight. Dr Loi adds that fertility drugs can also regulate the condition by inducing ovulation.

By the way, if you’re not sure that you’re ovulating, monitor your cervical mucus, Dr Loi advises. When you’re in the fertile period, your mucus is clear and stretchy, which enables the sperm to swim into the uterus more easily. But if your vaginal secretions are thick, then this “unfriendly” mucus prevents sperm from entering the uterus and you may need medical attention.

Other hormonal disorders that may hinder fertility include Hashimoto’s hypothyroidism, where the thyroid produces more oestrogen than necessary, which affects the hormones and, in turn, your menstrual cycle.

Some couples turn to traditional Chinese medical practices such as acupuncture can also “correct” your body’s system, “nourish the blood”, plus improve the circulation to regulate your blood flow, and subsequently, your menstrual cycle.