Couples are waiting longer to have children these days. The average age of first-time mums on the rise in Singapore and elsewhere. This is partly from choice, but a range of different fertility issues can play a part, particularly at an older age. Fortunately, for almost every issue, there is a potential solution. The team at Pacific Prime Singapore, tells us about the top five common fertility problems seen in Singapore, and how they can be addressed (with the help of health insurance!).
#1 Erectile Dysfunction
Erectile dysfunction (ED) is common among men around the world and many factors can cause an initial bout of ED. They include diabetes, heart disease, high cholesterol, high blood pressure, obesity and Parkinson’s disease. Subsequent attempts to maintain an erection can then be thwarted by the anxiety about ED potentially occurring.
According to Dr John Mulhall, who specialises in male sexual and reproductive medicine, at least a third of all men over the age of 40 experience ED. Stigma sees men in the region failing to seek treatment; living with the condition and withdrawal from relationships is a common occurrence. That’s why it’s so important for anyone experiencing ED to discuss it with their doctor.
#2 Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome (PCOS) is a disorder of the endocrine system in women. It results in the ovaries not releasing eggs (anovulation), the release of excessive male sex hormones in the body (hyperandrogenism) and polycystic ovaries. The specific causes aren’t currently known. Symptoms of the condition include menstrual irregularities, skin problems and obesity.
PCOS is the most common endocrine disorder, affecting 5 to 15% of women worldwide. There is no cure, but the condition can be managed to minimise its impact. Long-term risks of untreated PCOS include the development of cardiovascular disease, depression, mood swings, diabetes, weight gain and endometrial cancer. Treatment for PCOS can be as varied as the symptoms. The first line of defense is believed to be to control body weight to a Body Mass Index target below 25.
Fibroids are benign growths that can develop around the uterus. Only about one in three women with fibroids will experience symptoms, which include abdominal pain, pain during sex and menstruation pain. Fibroids can cause fertility problems where their placement obstructs sperm from entering the uterus. They can also block the fallopian tubes that allow eggs to enter the uterus, and weaken the uterine lining, making it difficult for fertilised eggs to develop.
Today, doctors diagnose fibroids with ultrasound technology, and generally remove them through a surgical procedure known as a myomectomy.
#4 Sperm count and quality problems
Some couples find that, while everything is functioning properly physically, there is an issue with sperm cells. A common problem is a low sperm count, reducing the chances of a sperm cell reaching the egg. A man might also have a normal number of sperm, yet with an abnormality in their mobility. It could also be some other aspect, making it hard for sperm to reach the egg or break through its membrane.
Efforts can be made to identify external behaviours or substances that may cause these issues; these can include lifestyle factors, medications or medical conditions. If there are no positive results, a couple will likely have to turn to an Assisted Reproductive Treatment such as in-vitro fertilisation.
Endometriosis is a common cause of infertility in women, affecting 10% of women in Singapore, whereby tissue that is usually found only inside the uterus grows on the outside as well. This extra tissue makes it problematic for fertilised eggs to implant in the uterine wall. It can also lower the quality of eggs produced.
Women over the age of 30 and those who haven’t had children are particularly at risk of developing the condition. Doctors believe it may be due to retrograde menstrual flow, genetics and/or an overabundance of estrogen. Symptoms include fatigue, pelvic and lower back pain, pain when making bowel movements, pain during sex, irregular vaginal bleeding and heavy or painful periods.
Normally, laparoscopic surgery is used to treat endometriosis. After which a woman with endometriosis is far more likely to find success with fertility treatments. Medications and hormone therapy may also be used.
Covering the costs of fertility treatment
While the Ministry of Health has created assisted conception programs for those with Medisave accounts. However, most expats in Singapore don’t have access to Medisave or subsidised public healthcare. Therefore, they’ll need to pay out of pocket for fertility treatment. With prices for fertility treatments at private medical facilities costing as much as $16,000 per cycle, the money quickly adds up! Not all medical insurance covers IVF or other fertility treatments, so finding the right plan is important. Get the help of medical insurance broker Pacific Prime Singapore for a comparison of health insurance plans featuring fertility treatment coverage.
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