Infertility is more common than many realise and identifying the underlying causes are key to determining the right treatment. Here, we discuss the various fertility screenings and tests available.
Infertility is defined as the condition in which a couple is unable to conceive after 12 months of regular sexual intercourse without using contraception. This condition may be due to either male or female factors, or both.
Couples who are struggling to conceive are encouraged to undergo fertility testing, especially if any of the following apply to them:
Age is a major contributing factor. A woman’s natural background fertility decreases by 1% every year after she reaches 35 years old. In general, it becomes harder for a woman to conceive after 35. Male fertility also declines with age, though the decline is typically less impactful than in women.
Among women, hormonal disorders, absent ovulation, blocked fallopian tubes, hostile cervical mucus and endometriosis can all be causes of infertility. Women might also be affected by Polycystic Ovarian Syndrome (PCOS). PCOS is an imbalance of hormones caused by excess androgens or male hormones and is one of the most common hormonal disorders in women of reproductive age. PCOS causes disruptions to menstrual cycles and can cause anovulation (absence of ovulation), which in turn causes infertility. Patients with PCOS might not display symptoms; as many as 50% never get diagnosed.
Male infertility, on the other hand, is often due to a low sperm count, poor sperm motility, poor sperm survival (vitality) or anormal sperm morphology resulting in failure to fertilise the egg.
Smoking, alcohol and obesity are the other factors that may also affect the chances of pregnancy.
If you and your partner are having trouble conceiving, we recommend going for a fertility screening with our fertility doctor. This assessment usually starts with a detailed medical history and physical examination to help determine the cause of the problem.
Semen analysis will be performed for the male partner in addition to the routine physical examination.
For women, fertility tests include:
Doctors will carefully analyse the test results in order to diagnose the causes of infertility and develop a suitable treatment plan. Depending on the test results, treatment like ovulation induction, surgery to remove growths or adhesions, Superovulation Intra-Uterine Insemination (SOIUI) or In-Vitro Fertilisation (IVF) may be recommended.
The duration of infertility testing depends on the types and number of tests involved. Therefore, this could range from a few days to weeks or months.
Basic tests such as blood investigations and ultrasound scans can be completed within a few days. However, more comprehensive tests such as hormonal evaluation, ovulation monitoring, Fallopian tubal patency assessment and other surgical procedures (e.g. laparoscopy and hysteroscopy) may extend the testing period especially if they need to be timed with a woman’s menstrual cycle.
Most infertility tests cause little to no discomfort. However, some procedures such as a hysterosalpingography (HSG) or a laparoscopy may cause temporary discomfort. These are normally manageable and your doctor will provide advice and medication to manage the discomfort.
While not all causes of infertility can be prevented, adopting a healthy lifestyle can improve one’s overall health and fertility. This includes maintaining a healthy weight, avoiding smoking and excessive alcohol consumption, managing stress and getting regular medical check-ups.
Dr Christopher Ng
Consultant Obstetrician & Gynaecologist
MBBS (Imperial College, UK), MMed (O&G) (S’pore),
FRANZCOG (Aust-NZ), FAMS (O&G) (S’pore)
Dr Christopher Ng is a dedicated obstetrician and gynaecologist with over 20 years of specialist experience in the field. As a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Dr Ng provides a wide range of services, including infertility screening and treatment. His expertise and commitment to reproductive health have made him a well-regarded doctor in Singapore.
