One of the key reasons for male infertility would be the development of sub-optimal sperms or problems with sperm delivery.
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One of the key reasons for male infertility would be the development of sub-optimal sperms or problems with sperm delivery.
Some treatment options include the intake of oral medication and/or surgery to address the sperm delivery or production problems.
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June 25, 2020
Various treatment options are available depending on the diagnosis of the infertility issue.
A woman who has ovulatory issues might be given clomiphene citrate to help her produce one or more eggs. Ultrasound scans can be scheduled to determine if the ovaries are responding.
If the ovaries do not respond to oral medication, injectable medicines would be recommended. These are administered daily by the patient or her spouse. The dosage and duration of the injections vary with the response to the medication.
If there are eggs which are suitable for ovulation, there are some procedures which could facilitate fertilization.
Intrauterine insemination (IUI) would be recommended for couples who are unable to conceive naturally even with the medications to stimulate the ovaries. An injection is administered to time the release of the mature eggs.
The husband’s semen sample is normally obtained on the morning of the procedure and processed in the laboratory. The processed sperm is then inserted via a catheter into the wife’s uterus to facilitate fertilization. The success of the procedure would be known about 2 weeks later.
In-vitro fertilization (IVF) is another option for couples who have found little success with the other treatment methods. After stimulating the ovaries with daily injections, the mature eggs are harvested via a procedure known as oocyte retrieval which is done under anesthesia.
A semen sample is also obtained from the husband. The sperm and egg would be fertilized in the laboratory. The fertilized egg is then cultivated in the laboratory for 3 – 5 days. These embryos will then be frozen, and later transferred into the uterus at a scheduled date. Up to 2 embryos can be transferred each time.
For couples who are considering or going for IVF, you might have heard about pre-implantation genetic testing, which includes PGD (Pre-implantation Genetic Diagnosis) and PGS (Pre-implantation Genetic Screening). Here are some common FAQs about these two tests to help you better understand their roles in the IVF process.
Both are tests performed before the embryo is implanted back into the woman, by taking some cells from the embryo. However, PGD is more specific, in that it is used to detect known genetic defects such as sickle cell anaemia, muscular dystrophy, cystic fibrosis and Tay-Sachs disease.
PGS on the other hand, looks at the overall chromosomal make-up i.e. DNA set of the embryo to detect for the presence of missing or extra chromosomes. As such, it can detect Down Syndrome or Edwards Syndrome.
PGD detects devastating genetic disorders that could be passed on to the child while PGS ensures that the embryo has a normal chromosomal make-up. An embryo with all 23 pairs of chromosomes and no genetic disorders is more likely to result in successful conception. Therefore, such screening helps to reduce the risk of miscarriage and increase the chances of success of an IVF cycle. It is important to note that there are still other factors that can affect the success of an IVF cycle.
PGD is recommended when there is a family history of genetic disorders, more so if the defective genes are recessive. A recessive gene will be expressed if both parents carry such a gene, yet the parents may not be aware that they carry a recessive gene.
PGS is recommended if there is a family history of sex-linked genetic disorders. Older women and women who might have low-quality eggs might also benefit from a PGS procedure. Couples who have had recurrent miscarriages or repeatedly fail IVF treatments might also be recommended to get a PGS test to understand why their pregnancies keep failing.
Currently, only PGD is allowed in Singapore. However, you are only allowed to get PGD if your family has a history of genetic disorders, and it can only be done in the public/government hospitals.
