Kegagalan Ereksi, Jangan Malu Lelaki!

Kegagalan ereksi, jangan malu lelaki!

Kegagalan ereksi atau mati pucuk yang dipanggil Erectile Dysfunction (ED) dalam Bahasa Inggeris ialah masalah kesihatan kelamin yang berlaku pada lelaki dan berkait rapat dengan kesuburan mereka. Masalah ini juga dilihat sebagai masalah umum yang berlaku di Malaysia. Walaupun kegagalan ereksi sering berlaku kepada lelaki lanjut usia, tetapi juga tidak boleh disangkal masalah ini juga menyasar lelaki muda yang tergolong di bawah umur 40-an.

Apakah yang menyebabkan masalah ereksi?

Kegagalan ereksi berlaku apabila seseorang lelaki itu tidak mencapai ketegangan yang optimum atau Erection Hardness Score (EHS). Ketegangan Gred 4 ialah tahap ereksi optimum yang perlu dicapai oleh lelaki, namun mereka yang berhadapan dengan kegagalan ereksi sering mengalami tahap kepuasan yang jauh lebih rendah dalam semua aspek hubungan kelamin.

Antara faktor yang menyebabkan masalah ereksi adalah dari segi tahap kesihatan dan masalah fizikal. Jika seseorang lelaki itu pernah mengalami kecederaan pada saraf dan gangguan peredaran darah pada kelamin lelaki, maka boleh menyumbang kepada kegagalan ereksi.

Jika seseorang lelaki itu pernah melakukan pembedahan kanser prostat juga boleh menyebabkan seseorang itu gagal ereksi.

Kesihatan lain yang terjejas

Ramai yang beranggapan bahawa kegagalan ereksi terjadi akibat kecederaan, namun pakar urologi juga menekankan bahawa faktor lain dari segi tahap kesihatan seseorang lelaki itu juga turut menyumbang kepada masalah ini.

Antara masalah kesihatan yang menjadi penyebab kepada masalah ini adalah:-

  1. Darah tinggi dan kolesterol
  2. Kemurungan
  3. Kencing manis
  4. Kesan sampingan sesetengah ubat-ubatan
  5. Ketagihan alkohol dan merokok
  6. Kurang aktiviti fizikal
  7. Masalah jantung
  8. Penyakit kardiovaskular
  9. Simptom saluran kencing lebih rendah (LUTS)
  10. Tekanan tinggi

Adakah masalah ereksi tanda-tanda awal ketidaksuburan?

Lelaki yang mengalami kegagalan ereksi tidak mampu untuk berejakulasi dan tidak mampu untuk menimang cahaya mata. Oleh itu, mereka haruslah melakukan beberapa ujian saringan kesuburan untuk mengenal pasti punca permasalahan tersebut.

Bolehkah masalah ereksi dirawati?

Walaupun masalah kegagalan ereksi kedengaran serius, namun masalah ini boleh dirawati dengan menjalankan beberapa pemeriksaan seperti melakukan pemeriksaan fizikal untuk memeriksa jika terdapat benjolan atau bengkak pada testis, pemeriksaan darah, air kencing dan ultrasound untuk memeriksa peredaran darah pada alat kelamin lelaki.

Cara melindungi masalah ereksi

Walaupun kekerapan kegagalan ereksi meningkat dengan usia, ia boleh dirawat menggunakan ubatan atau membuat pilihan gaya hidup sihat seperti bersenam, mengawal pengambilan alkohol, berhenti merokok dan mengubah tabiat makan.

Jumpa dengan pakar urologi atau pakar kesuburan enam bulan sekali untuk memeriksa tahap kesihatan diri anda serta beriadah untuk mengurangkan tekanan diri. Jika anda melihat tanda-tanda depresi sila berjumpa dengan pakar segera.

Ingat, jangan sesekali ambil keputusan sendiri untuk mengubati masalah ini dengan membeli ubat-ubatan yang dijual di atas talian dan bergantung pada maklumat daripada Internet semata-mata. Sikap anda ini boleh memudaratkan kesihatan diri kerana tidak semua maklumat dalam Internet boleh dipercayai dan ubat yang diperoleh menerusi sumber kurang sahih mungkin mengandungi bahan aktif berbahaya atau tidak sah.

Bagaimana kami boleh bantu anda?

Di TMC Fertility, kami mempunyai pakar-pakar kesuburan yang berpengalaman dan mampu memberikan rawatan khusus untuk masalah ketidaksuburan anda.

Masalah kegagalan ereksi terjadi akibat beberapa faktor dan pakar kesuburan kami akan melakukan beberapa ujian saringan untuk mengenal pasti punca sebenar masalah anda.

Apa yang anda perlu lakukan? Hubungi kami untuk sebarang maklumat dan pertanyaan di talian khidmat pelanggan kami di +6018-211 1088 atau terus emel di ivf.info@tmclife.com.

3 Burning Questions on Fertility Treatments

From how long will it take to what do I need to do? Questions are constantly being raised about fertility treatments. Obstetrician, Gynaecologist and Fertility Specialist at TMC Fertility Centre, Puchong branch, Dr. Chong Kuoh Ren demystifies your burning questions on fertility treatments.

  1. My husband and I are thinking of seeking fertility treatments. When is the best time for us to visit a fertility specialist?

Examination during different times of the menstrual cycle will reveal different information. For example, during the first few days of menses, there shouldn’t be any obvious cysts detected, therefore any cysts seen early in the cycle is unusual, and can be identified easily. During the middle of the cycle, the response of the ovaries and the endometrium (lining of the womb) can be assessed. A week before the menses is due, evidence whether ovulation has occurred or not can be determined. So, any time of the cycle is a good time to visit a fertility specialist.

  1. I have undergone a vasectomy earlier in my life. I recently got married and my wife and I are planning on starting a family. I would like to enquire if the process can be reversed?

Reversal of vasectomy can be done by a urologist as a day-care procedure. Good outcome is expected if reversal is done within 10 years of the original vasectomy. The longer the interval between the original procedure and the reversal surgery, the more likely sperm antibodies or other blockages may develop.

  1. I hear about Pre-Implantation Genetic Testing for Monogenic and (PGT-M) Pre-Implantation Genetic Testing for Aneuploidy and (PGT-A). What are PGT-M and PGT-A? How will this benefit my baby and are there any risks involved with these tests?

PGT-M and PGT-A testing is done in conjunction with an IVF cycle, whereby one or two cells from growing Day 3 embryos (sometimes Day 5 as well) are removed and tested for genetic diseases or abnormalities. Only those tested ‘normal’ will be transferred back to the womb.

PGT-M is helpful when either one of the couple have a certain inheritable disease, such as Thalassemia or Sickle Cell Disease and they do not wish to pass on the gene to their children.

PGT-A is used to screen the embryos for normal chromosome numbers (46 chromosomes in humans). PGT-A is recommended for the following patients:

  1. Patients undergoing IVF at an advanced age, more than 38 years old (due to a higher percentage of abnormal embryos produced by this age group)
  2. Patients with repeated IVF failures at any age
  3. Patients with repeated miscarriages
  4. Patients with chromosomal problems (for example, translocations)

There is a small risk of traumatising the embryos when the test is done, therefore it should be done in a centre that has experience with the technology.
Dr Chong Kuoh Ren

Dr Chong Kuoh Ren
Obstetrician & Gynaecologist and Fertility Specialist
TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com).

For more enquiries or to schedule an appointment, please call: +60 3 8076 7111 or email us at tmcfertility.pc@tmclife.com

24-hour Careline (WhatsApp available):
+60 18 2111 088 | +60 16 2111 357 | +60 18 2111 405

Understanding In-Vitro Fertilisation (IVF) & Intra Cytoplasmic Sperm Injection (ICSI)

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Fertility treatments have advanced tremendously over the years. All these advancements have helped countless couples achieve their dreams of parenthood. For fertility specialist Dr Fabian James Kurian, choosing which of these treatments is best for a couple will depend on the findings after an initial assessment of both the woman and the man. While a woman’s age and underlying cause of fertility problems do matter, so does sperm quality.

“In a natural cycle, women usually produce one follicle and one egg per month. In IVF, we try to stimulate the ovary to produce more follicles, thereby giving us more eggs that we can fertilise with the male partner’s sperm,” explains Dr Fabian. “We then place a predetermined concentration of sperm in a well with the egg. Nature will help sort out the best sperm in that group to fertilise that egg.”

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As for ICSI, he says that the process involves selecting a single viable normal sperm and then injecting it into a suitable egg to increase the chances of fertilisation. This is done when there are abnormalities in the sperm, in terms of concentration (count), motility (movement) or morphology (shape). Sperm quality can be quite variable, and as such, the decision if ICSI is required is based on the sperm parameters on the day the eggs are retrieved.

The embryo transfer is a critically important procedure and is the last step of the process. Embryos are transferred to the uterus several days after fertilisation and hormonal treatments are administered to promote embryo implantation into the uterine lining. Any extra embryos are frozen for future use.

Men may not always be aware of their sperm deficiency, according to Dr Fabian. “They may have very low sperm counts or no sperm at all (azoospermia),” he notes. They usually function just fine sexually, but sometimes, it is only after they get tested that they are made aware of the problem.”

It is best to seek help earlier, the success of fertility treatments is crucially related to women’s age. Women above 35 who have been trying for more than 6 months should visit a fertility specialist with their spouse to get a full evaluation and to possibly start on a treatment plan.

“As couples start on their journey towards parenthood, they should understand that this is a journey that should be made together. It is not about what problem or where the fault it is, rather, it is about supporting each other and working towards the solution.”

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Dr Fabian James Kurian
Obstetrician & Gynaecologist and Fertility Specialist
TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com).

For more enquiries or to schedule an appointment, please call: +60 7 278 0088 or email us at tmcfertility.jb@tmclife.com

24-hour Careline : +60 18 2111 088 | +60 16 2111 357 | +60 18 2111 405

 

 

Apa yang anda perlu tahu tentang “Secondary Infertility”?

Secondary infertility bukanlah sesuatu perkara pelik yang berlaku kepada pasangan yang telah memiliki anak secara normal sebelum ini. Secondary infertility merupakan ketidakupayaan untuk hamil secara semulajadi walaupun sudah memiliki anak sulung.

Jika ada para ibu di luar sana yang sedang mencuba selama setahun untuk hamil kali kedua namun tidak berjaya maka masalah kesuburan anda dikategorikan sebagai secondary infertility.

Di bawah merupakan antara sebab secondary infertility berlaku, jika anda:-

  • Berumur lebih 35 tahun
  • Masalah sperma pasangan anda
  • Mempunyai masalah Sindrom Ovari Polisistik (PCOS)
  • Mempunyai berat badan yang berlebihan
  • Kerosakan pada tiub fallopian

Jika anda salah seorang yang berhadapan dengan masalah di atas anda tidak perlu risau kerana masalah ini boleh diatasi dengan bantuan pakar kesuburan di TMC Fertility.

Lazimnya, masalah secondary infertility boleh diatasi dengan bantuan ubat-ubatan kesuburan, Intrauterine Insemination (IUI) dan In-vitro Fertilization.

Di bawah merupakan antara kisah-kisah pesakit kami yang berhadapan dengan masalah ini:

  • Madam Y berhadapan dengan secondary infertility ketika usia perkahwinnya menginjak 6 tahun. Dengan bantuan pakar kesubruan TMC Fertility, Madam Y telah menjalani rawatan IVF serta pemeriksaan kromosom (PGT-A). Dan kini Madam Y berjaya hamil untuk kali kedua setelah melalukan Frozen Embryo transfer.
  • Puan F bukan saja pernah alami detik hitam di mana pernah mengalami keguguran sebanyak dua kali tapi juga berhadapan dengan secondary infertility. Keguguran berlaku bukan atas sebab badan atau rahim Puan F tidak baik tapi ianya disebabkan oleh morfologi sperma atau rupa bentuk sperma yang tidak normal. Selepas mendapatkan rawatan IVF di TMC Fertility, alhamdulillah Puan F disahkan hamil.
  • Madam Z mengalami beberapa komplikasi dalam percubaan untuk hamil kali kedua, meskipun beliau tidak mempunyai masalah dengan kehamilan pertama (secara semulajadi). Setelah melahirkan bayi sulungnya, beliau juga mengalami keguguran sebanyak tiga kali. Merujuk kepada keadaannya, pakar kami menasihatkannya untuk menjalani rawatan IVF dan PGT-A (ujian genetik yang dilakukan pada embrio) untuk memilih embrio yang sihat supaay dapat peluang untuk hamil. Walaupun Madam Z menderita sakit, tertekan, letih pada peringkat awal, namun, ganjaran yang dia terima di pengakhirannya sangat berharga. Ujian darahnya menunjukkan dia hamil!

Jika anda ingin mengetahui lebih lanjut tentang secondary infertility, sila layari laman sesawang kami: https://www.tmcfertility.com/ atau bersembang santai bersama pakar-pakar kami: https://bit.ly/2Cx6lgi

A Greater Chance of A Healthy Baby with Pre-Implantation Genetic Testing (PGT)

pgt coverNaturally, every parent-to-be wants a healthy child. Unfortunately, the chance of producing abnormal embryos becomes much higher as women age, as fertility rates fall after 35. Pre-implantation genetic testing (PGT), a premium service offered by TMC Fertility Centre, helps to identify the “chromosomally normal” embryos that are the healthiest, to be implanted during an IVF cycle.

How is PGT testing done? Embryos fertilised in the lab will divide into individual cells known as blastomeres. A blastomere is then collected through a biopsy and tested for genetic and chromosomal abnormalities. PGT will help to identify if genetic/chromosomal abnormalities are present in IVF embryos. This in turn helps couples make informed decisions about what to do during the IVF process. Embryos unaffected by genetic or chromosomal abnormalities are then selected for transfer to the uterus.

According to fertility specialist Dr Navdeep Singh Pannu, there are two main types of PGT to suit the needs of different couples. Next Generation Sequencing (NGS) or 24-chromosome aneuploidy screening is usually recommended for women above 40 or who have had recurrent miscarriages. All 24 chromosomes can be screened at the same time to confirm that the embryo has the correct number of chromosomes before being transferred to the uterus. In fact, TMC Fertility is the first in Asia to offer this technology.

For couples that have inherited genetic problems, the polymerase chain reaction technique detects certain common genetic disorders, such as haemophilia, alpha-thalassemia or beta-thalassemia, through a highly sensitive analysis of the embryo’s DNA.

However, Dr Navdeep explains that sometimes, structural problems such as cleft lip palates are unavoidable – these occur even in healthy embryos. But he can ensure that there will be no chromosomal abnormalities, an increased implantation rate and a higher chance of success.

Dr Navdeep Singh Pannu

Dr Navdeep Singh Pannu
Obstetrician & Gynaecologist and Fertility Specialist at TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com).

For more enquiries or to schedule an appointment, please call: +60 3 6287 1000 or email us at enquiries.ivf@tmclife.com

24-hour Careline : +60 18 2111 088 | +60 16 2111 357 | +60 18 2111 405

Common Infertility Problems Among Women : Part 2 – Your Treatment Options


Your Treatment Options

Endometriosis and PCOS
The treatment options for the gynaecological medical conditions mentioned, depends very much on the diagnosis and severity of the condition.

“For patients who have been diagnosed with PCOS or endometriosis, medication will usually be the first line of treatment,” says Dr.Nurhazinat. One treatment example is the prescription of hormone treatments to regulate your menstrual cycle. Aside from that, the doctor would also advice the patient to maintain a healthy weight and go on a healthy diet.

“However, if medications are not a suitable treatment or was not a successful one, the following treatment option would be surgery,” she explains. “For patients with PCOS, a surgery known as ovarian drilling will be performed. This surgery will help to regulate your hormones, induce ovulation and regulate your menstrual cycle.”

As for patients with endometriosis on the other hand, a laparoscopic procedure will be performed to treat the condition.” At the same time, if a doctor suspects other fertility issues such as one which involves your fallopian tube, the doctor will be able to check on that as well,” adds Dr. Nurhazinat.

Ovarian Cysts
For patients diagnosed with ovarian cysts, treatments can range from medication such as hormonal pills to surgery. For some, the cysts may even go away on its own.

However, if it doesn’t and becomes a cause for concern, your doctor will perform a surgery to remove the cyst and this increases your chances of getting pregnant.

Pelvic Inflammatory Disease
“For patients with PID, a doctor will usually prescribe antibiotics to treat the condition,” she says. However, if the treatment of antibiotics was not able to treat the condition, a laparoscopic surgery may be advised.

Uterine Fibroids
Treatment for uterine fibroids depends very much on the severity of your condition such as the size of the fibroids, its position and the symptoms it causes which can include heavy periods.

“If the fibroid is small, less than three centimetres and does not present much symptoms which is affecting the patient’s quality of life, then the doctor will most probably observe the patient’s situation before proceeding with treatment,” explains Dr. Nurhazinat. “However, if the fibroid is above five centimetres in size and causes symptoms which affects a patient or situated close to the endometrium lining, then the doctor may perform a surgery to remove the fibroids. This will increase a patient’s chance of conceiving.”

Conceiving a baby

After seeking treatment, the next aim is to get pregnant.

Firstly, Dr. Nurhazinat clarifies that, “For a healthy woman who does not have any gynaecological medical conditions, her chances of getting pregnant is not 100 percent but about 10 to 20 percent each month. Hence, our aim as a medical expert is to achieve this for our patients as well.”

After seeking treatment, your doctor may advice you to try conceiving the natural way. “Generally, the patient will be advised to try this method for about six months to a year. However, this also depends on the woman’s age,” she says. The reason why fertility specialist have taken your age into account, is because, as you get older, this will decrease your chances of getting pregnant.

So, what is the next step if you were not able to conceive within the period of time as discussed with your doctor?

Dr.Nurhazinat says that, “If the patient and her partner has tried every other method but was not able to conceive, medical assisted reproduction will be suggested. Treatment options such as intrauterine insemination (IUI) and In-Vitro Fertilisation (IVF) will be explored.”

The former, IUI is a fertility treatment which involves injecting the sperm into the woman’s uterus to facilitate fertilisation. The latter, on the other hand, is a treatment which involves combining the ovum and sperm in a procedure which will be conducted in a procedure which will be conducted in a laboratory. After the ovum and sperm has been fertilised and becomes embryo, the fertility specialist will then, place the embryo in the womb and the couple’s pregnancy journey will continue as normal.

Gynaecological medical conditions can occur at any stage of your life. “What is most important is that you are able to control the disease,” says Dr. Nurhazinat.

Her parting advice to women is, “Go for regular health check-ups which should be annually or once in every two years. If you have been diagnosed with a medical condition, seek treatment as this help to increase your chances of getting pregnant.”

As for couples who are planning to start a family, she says, “start family planning as early as possible but of course, it is important to ensure that both husband and wife are ready to embark on this journey. You should also maintain a healthy weight, lifestyle and have a moderate intake of alcohol.”
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Dr. Nurhazinat Bt Mohamed Yunus is an Obstetrician & Gynaecologist and Fertility Specialist at TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com). For more enquiries or to schedule an appointment, please call: +60 3 6287 1000 or email us at enquiries.ivf@tmclife.com

24-hour Careline : +60 18 2111 088 | +60 16 2111 357 | +60 18 2111 405

Common Infertility Problems Among Women

WhatsApp Image 2019-03-22 at 12.03.04 PMA healthy reproductive system is essential to increase one’s success of conceiving a child. 30 percent of women have infertility issues and treatment will most probably be needed if you would like to have a baby.

There are many reasons which can cause a woman to become infertile. Among them are gynaecological medical conditions. Consultant Obstetrician and Gynaecologist and Fertility Specialist from TMC Fertility Centre which is located in Thomson Hospital, Dr. Nurhazinat Bt Mohamed Yunus shares about common gynaecological medical issues which can cause infertility.

The Possibilities
From endometriosis to Polycystic Ovarian Syndrome (PCOS), these gynaecological medical conditions may sound familiar to many. However, did you know that it can lead to infertility if left untreated?

Though, before understanding the different medical conditions, Dr. Nurhazinat believes that it is best to learn about the symptoms that every woman should look out for.

“Any abnormal symptoms related to a woman’s reproductive system can be a sign of a gynaecological medical condition,” she says.

There are a few common symptoms you should be aware of. Dr. Nurhazinat explains that they include:

  • A short menstrual cycle of 24 days or less
  • An infrequent menstrual cycle which can take about 40 days for one cycle
  • Severe pain during your period which will require medical attention or a day off from work
  • Heavy bleeding (which usually requires about four to five changes of sanitary pads daily)
  • A long menses duration of 10 days or more

“If you are experiencing any of the symptoms above, this can indicate a possible underlying gynaecological medical condition,” she says.

Common Gynaecological Medical Conditions
“There are five common causes of the symptoms as mentioned,” says Dr. Nurhazinat.

The common medical conditions which can cause infertility includes:

  • Endometriosis – This condition occurs when a tissue found in your uterine lining, grows outside of your uterus. Endometriosis can cause severe pain especially during your period.
  • Ovarian Cysts – Ovarian cysts are sacs that are filled with fluid, which can be formed in the ovaries.
  • Polycystic Ovarian Syndrome (PCOS) – When your hormones are imbalanced, this can lead to PCOS. What happens is that the ovaries will grow small cysts, forming like a chain of pearls.
  • Uterine Fibroid – Often occurs during childbearing years, uterine fibroids are non-cancerous growths.
  • Pelvic Inflammatory Disease (PID) – PID occurs when the cervix is infected with bacteria due to a sexually transmitted disease. This includes cases such as gonorrhea and chlamydia.

“Besides these five conditions, there are also other less common conditions which you should also be aware of such as endometrial polyps,” she highlights. If you have been diagnosed with any of these conditions, treatment is widely available.

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Dr. Nurhazinat Bt Mohamed Yunus is an Obstetrician & Gynaecologist and Fertility Specialist at TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com). For more enquiries or to schedule an appointment, please call: +60 3 6287 1000 or email us at enquiries.ivf@tmclife.com

24-hour Careline : +60 18 2111 088 | +60 16 2111 357 | +60 18 2111 405