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Fertility Screening for Couples


As the saying goes; it takes two to tango, the same applies to having a baby. This is why infertility investigation and treatment is best done as a couple.

More and more couples are choosing to start their families later and many are finding out they may having trouble conceiving.

The reason behind this is fertility decreases as a woman gets older. Even the success of assisted reproductive methods such as in-vitro fertilisation (IVF) decreases as well.

Couples are encouraged to seek infertility screening earlier if they are still not able to conceive despite having regular unprotected sexual intercourse during the woman’s fertile period (during ovulation). Fertility screening for couples might allow for any underlying issues to be detected and treated earlier to the chances of success.

This bit is a little lengthy but all factors play an important role. Besides obtaining a thorough medical history from the couple, which includes their age, duration of trying for a baby, sexual history, any history of sexually transmitted diseases, history of previous surgery, history of previous pregnancies/miscarriages and menstrual history, other tests may be included in a infertility assessment.

What kind of tests are used for couple’s fertility screening?
1. Hormonal blood tests

Various hormonal blood tests may be looked at such as follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E3).

There are many more hormones that are investigated but there are just too many to list here. These hormonal blood tests aid in identifying why a woman may not be menstruating, or having irregular periods, or even recurrent miscarriages.

2. Ultrasound pelvis

An ultrasound of the pelvis will be useful in looking at the woman’s uterus and ovaries. This can detect conditions that can affect fertility including polycystic ovarian syndrome, fibroids, and pelvic infections.

3. Hysterosalpingogram

A hysterosalpingogram or HSG is a dynamic x-ray of the uterus and fallopian tubes which is performed by injecting dye into the uterus via the cervix.

It is used to assess the anatomy of the endometrial lining of the uterus and to assess if there is any blockage of the fallopian tubes.

4. Semen analysis

Semen analysis is a very important test and should be done early in the screening. The test encompasses sperm count, sperm movement and sperm quality, among many other things. Essentially this identifies if the sperm is good enough in quality and number to have a good chance of fertilising an egg.

What should you do if you have been trying for a baby and have been unsuccessful?

If you and your partner have been trying actively for at least 1 year (woman’s age under 35 years old) or 6 months (woman’s age >35 years old) and have not been successful, you should both see a medical professional for further infertility screening as the earlier you pick up a problem, the earlier you can rectify it. Remember, fertility starts to decline as you get older and drastically declines after the age of 35 years old.

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About Dr. Sim Li Kun

Dr Sim Li Kun graduated from the University of Bristol, UK in 2009 where she has worked for 2 years before moving to Singapore. Currently she is practicing in a private medical group, Dr Tan & partners, in Singapore which has a special interest in men's and women's health, as well as tackling HIV and the spread of STDs.

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