Endometriosis is a common cause of infertility. It is a 
progressive disease where the lining of the womb (endometrial tissues) is spilled into other parts of the reproductive organs including the fallopian tubes, ovaries and the back of the womb. These abnormal and wayward endometrial tissues bleed every month during menstruation. The surrounding areas become irritated and form scars. Infertility results from blocked tube, irregular or defective ovulation and failure of the fertilised egg implanting itself in the womb.

The recurrence rate is high and there is no definitive cure. The disease will regress only at menopause when there is no more stimulation of the endometrial tissues by the ovarian hormones.

Azoospermia is a male fertility issue many men face where there is an undetectable amount of sperm in a man’s semen. The cause of Azoospermia can be varied and there will be different treatment options available depending on the cause. Some examples of treatment for Azoospermia are, microsurgical reconstruction for causes due to blockage and medical treatment for non-obstructive Azoospermia.

Do check on your egg bank by having a ultrasound during the early days of your menses. If you have many follicles, that would mean good ovarian reserve and a better chance.

Hyperthyroidism (overactive thyroid) is a condition in which the thyroid gland – a butterfly-shaped organ located in the base of the neck – produces excessive hormone, known as thyroxine. This condition can cause heavy menses or absence of menses and can affect your fertility. If your condition is managed and controlled well, your menses should be regular. Don’t delay. You should plan early for conception.

It really depends on the cause of the cyst and it's hard to generalise. Do trust your doctor to see you through the various possibilities as sometimes functional cysts may actually disappear, but other types will not and may have to be dealt with medically or surgically. Conception can be more difficult especially if it is a endometriotic cyst.

Adenomyosis makes it difficult for the pregnancy to hold, but it really depends on how extensive the adenomyosis is and this may have to be treated medically or surgically prior to conception again. 

In general, a couple below 35 years of age who does not have any obvious problems, for example, irregular periods, is advised to seek specialised medical attention if they do not conceive after one year of regular intercourse without the use of contraceptives.

A couple can go to a gynaecologist or reproductive medicine specialist for fertility checks.

The specialist will have to conduct some tests for the couple, i.e. to evaluate the condition of
sperms and fallopian tubes, ovarian reserves and if the wife is ovulating. Depending on their
conditions, the specialist will recommend the appropriate course of treatment.

It is important to identify the underlying cause of subfertility in each individual case to decide on the
next course of treatment. Although fertility treatment programmes such as IVF (In-Vitro Fertilisation)
and ICSI (Intra-Cytoplasmic Sperm Injection) may offer the highest success rates, in some couples
simple measures like induction of ovulation, intrauterine insemination, surgical correction of
endometriosis, removal of polyps may help them conceive naturally. The success rates also depend
on various factors, such as the age of the woman, the underlying cause of the fertility problem.

Medical regulations in Singapore allows IVF only for married couples recognised by the laws of Singapore. Current regulations in Singapore allows eggs to be stored if there are medical reasons for example, those who have AHD cancer treatment and are still single and wish to try and preserve fertility for the future or those who are wanting to preserve fertility prior to treatments. Men who are in similar positions can also opt to freeze their semen or those who engage in high contact sports and risk injury may also want to safeguard their fertility potential. 

If you are above 35 and have been trying for six months without conceiving, please seek medical attention.

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