“Getting pregnant is not as easy as ABC and… many couples face difficulties conceiving.”
This was shared by Associate Professor Tan Thiam Chye, Head and Senior Consultant, Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital (KKH), at I Love Children’s (ILC) fertility wellness talk, held at Hillion Mall in September. The talk was part of ILC’s Know Your FERTILITY WELLNESS 2018 campaign.
It is a fact that Singaporeans are getting married later and as a result the total fertility rate dipped to an all-time low of 1.16 in 2017. It does not help that it is known that fertility in women and men decline after 30 years of age and 35 years of age respectively.
According to A/Prof Tan, the optimal age for conception for a woman is 24 and 25 years old. Yet, at that age, most young adults in Singapore would be busy working or studying. Many might miss the optimal conception window.
Even celebrity mom and singer-song writer, Tay Kewei shared: “At that age, my thoughts of marriage and having children were far in the horizon.”
A/Prof Tan said: “In early 2000, the norm was to have small families. However, in the last five years, I see a shift in the mindset of Singaporean women. Many of my patients born in the 1990s have told me they want to have big families. Some want five to six children. It is a return to the days of big families. I’m glad for this shift in mindset and I hope the momentum will continue.”
Kewei agreed with A/Prof Tan, and said: “I prefer to have at least two children, ideally three. I’m 35 this year and I only gave birth last year. I wished I had started earlier.”
Fertility-related questions were posed to A/Prof Tan Thiam Chye at the wellness talk. He addressed these questions:
You can still get pregnant and have healthy children. However, statistics do show that fertility drops with age, making it more difficult to conceive. Also, as one gets older, the possibilities of a high-risk pregnancy will increase.
Endometriosis is fairly common in women in their reproductive age. It is a condition where the menses flow back into the pelvic area and the ovaries.
Rather than flowing outwards, the blood is collected in the ovaries, forming chocolate cysts. As a result, it causes a blockage in the fallopian tubes which could lead to difficulties in conceiving as both the sperm and egg are unable to travel through the tubes. This condition can be treated surgically. Thereafter, her chances to conceive would return to normal.
Excessive exercise can cause infertility but this usually happens to competitive athletes. When a person exercises too much, the body goes into a stressed state, causing the hormones to drop. To keep the hormonal balance in check, one should exercise regularly 3 to 4 times a week for 30 minutes.
For women in poor health, the reproductive functions could be affected first and this is a natural protective mechanism of the body.
Pregnancy takes a heavy toll on the body. During pregnancy, the best form of exercise is swimming as it relieves muscle tension.
Most women gain an average of 10 to12 kg throughout the entire pregnancy. It is best to shed this weight within six months of delivery.
Beyond that, it becomes difficult to lose the weight. This weight can add on with the second and/or subsequent pregnancy. Breastfeeding burns about 200 to 300 calories a day so with a balanced diet and exercise, it can help hasten weight loss.
Fertility Health Check
So is it necessary for both husband and wife to go for a fertility health check? Dr Tan Kai Lit, an Obstetrician and Gynaecologist and Maternal Fetal Medicine Clinician with Thomson Women’s Clinic answer some questions.
“1 in 6 couples face difficulties conceiving”
Most couples can conceive within one year of trying. Couples trying regularly for a year without success should go for a fertility health check. Newlyweds may choose to go for a fertility health check to understand their fertility wellness too.
Besides going for a fertility health check, I usually advise couples to have regular intercourse about two to three times a week to increase their chances of conception.
The Fertility Health Check involves both the male and female.
Males undergo a sperm analysis. For females, there are several tests to determine if anything is causing a disruption to her ovulation. She will undergo hormonal tests, an ultrasound to check for the presence of cysts and fibroids, and a scan to determine the patency of the fallopian tube.
A fertility health check takes approximately 50 minutes.
| Procedure | Time Taken |
| Consultation | 15 - 20 minutes |
| Examination | 10 - 15 minutes |
| Blood tests | 2 minutes |
| Ultrasound Scan | 10 - 15 minutes |
| Total Time | 50 minutes |
The Fertility Health Check is not invasive. It may be uncomfortable for women but not painful.
Some women may undergo a speculum examination. A speculum checks the cervix and involves a pap smear. It helps visualise the neck of the womb and uterus. Sometimes, the uterus becomes large due to the fibroids. Other times, the doctor will check the fallopian tubes.
The blood test checks the hormones as they affect the menstrual cycle and ovulation. There are many hormones that affect menstrual regularity. If you have regular menses, there should be no problems to your hormonal profile. As part of due diligence however, the woman should go for a Fertility Health Check.
The costs differ from hospital to hospital. Thomson Fertility Centre has a Fertility Health Check package for both husband and wife that cost $450 which consists of the following:
• Semen Analysis (Husband)
• Ultrasound scan (Wife)
• Hormone blood test (Wife)
• Review of the results with a gynae
Couples can also get a referral letter from the Polyclinic to KKH, NUH or SGH for a subsidised rate.
There are many foods that claim to help boost fertility. Natural aphrodisiacs like oysters enhance fertility as it contains micro-nutrients like Zinc. However, more importantly, women need folic acid.
Folic acid is Vitamin B9, and comes from specific sources: largely fresh, leafy vegetables and is an important hormone for fertility. It facilitates a baby’s healthy development; reduces spine and brain abnormalities; and helps improve speech development.
Although foods have folic acid, it is good to also supplement in the diet, Folic acid can be readily bought from a pharmacy. It is recommended to consume it three months before trying to conceive.
I Love Children thanks Associate Professor Tan Thiam Chye and Dr Tan Kai Lit for their contribution at the Know Your Fertility Wellness 2018 campaign roadshow talks.