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

Letting It Out

Letting It Out
By Choy Xue Min, Registered Counsellor



As a counsellor for patients undergoing fertility treatments, tears are a part and parcel of my work. Some are tears of joy; others are tears of frustration and sadness.

When a couple does not succeed in becoming pregnant after undergoing IVF, it is common for them to shed tears, especially the woman. After an anxiety-ridden 2-week wait, some women may feel overwhelmed with sadness when their pregnancy test comes out negative. This is when they tend to cry, in front of the doctor, nurses and counsellor.

It is normal to feel sad, as sadness is among the 6 universal feelings. The other universal feelings are anger, surprise, fear, disgust and happiness. When we are sad, we may feel the need to cry, but we tend to hold back our tears out of embarrassment or to avoid negative judgement or unnecessary attention.

Speaking to a counsellor allows you to let out your emotions without the fear of being labelled as weak or attention-seeking. Crying is not a sign of weakness. Physiologically, it helps to release pent-up emotions and eliminate stress hormones from your system, which is why you always feel better after a good bout of crying.

Tears shed are not of sadness alone. During our support group meetings for IVF couples, I sometimes see the husband or wife shedding tears of joy or appreciation for one another. The IVF journey is not an easy path, and it is always the love for each other that makes the journey less dreadful.

Husbands usually do not cry when receiving sad news about unsuccessful pregnancies, but they undoubtedly feel the pain just as much. However, they have to remain strong and steadfast in order to provide emotional support to their wives in those crucial moments.

Seeing their wives undergo the treatment with perseverance and determination often touches the husbands, creating a stronger bond between them in the process. Having a shared goal, in this instance of wanting a baby, is a strong connecting factor for a couple, thus it is important for both the husband and wife to be equally committed to treatment.

So if you are feeling tearful, don’t be afraid to let it flow. Keeping it cooped up will only aggravate your pain and sense of loneliness. Speak to a counsellor or join our support group to meet others. Just remember that you need not walk alone.


Choy Xue Min is a Registered Licensed Counsellor with a Master degree in Counselling Psychology from Universiti Kebangsaan Malaysia (UKM). Passionate about helping couples and families maintain harmonious relationships, she is a certified Trainer for the’ Journey to Intimacy’ workshop by Dr Huang Wei-Jen from Northwestern University, USA, as well as a Trainer for Mental Health Facilitator Program by the National Board for Certified Counselors, USA. The mother of two boys believes in the concept of mindfulness and encourages assertive communication in any form of relationship.


IVF pushing 40? I was lucky… but I wish I’d started earlier

British actress ALICE EVANS reveals her struggle to have a baby at 38 – and how her family is now the real life Fantastic Four

Alice Evans and Welsh star Ioan Gruffudd were living the Hollywood dream. 

The two British actors met on the set of the Disney hit 102 Dalmatians, soon became a couple and married. Ioan landed starring roles in Fantastic Four and his own TV series, Forever, while Alice worked constantly in hit shows such as Lost and The Vampire Diaries.

Yet behind the success was a secret heartache as they fought – and failed – to start the family they both longed for.

Today, in a brave and extraordinarily candid account, Alice, now 44, writes about the highs and lows of their desperate journey through IVF – and issues a warning to the millions of young women like her who might be tempted to leave it late to start a family…

I ALWAYS knew I would have children. And by that I don’t mean I always hoped or dreamed. No, I knew. Because having children – or so my 13-year-old self thought – was inevitable.

It would happen, on schedule, after I was done chasing all the important things I wanted in life: to become an actress, learn foreign languages, live in France, find a man who loved me as much as I loved him, and, obviously, meet Shakin’ Stevens.

It was optimistic of me to want all those things, as I grew up in a very ordinary family in an ordinary house in Bristol and went to a pretty rough comprehensive where learning how to avoid being beaten up was a skill that served you a lot better than planning a career.

But I had it all planned out. By the age of 50, I would kick back and watch my large brood of kids running around – so I’d better make sure I had the money for that before I did something stupid like have unprotected sex.

How very wrong I was. The fact is that Ioan and I left it late – very late – to start our family. And the worst thing is, it was deliberate.

Looking back I ask myself how could we have been so complacent about the simple facts of life. But that’s what they say: When you make plans, God laughs.

So we found ourselves playing a traumatic and expensive IVF lottery game that we were lucky to win.

And if just one person reading this makes a decision to start trying for a baby at 33 instead of 36, or if a single woman makes enquiries about the best way to freeze her eggs, then sharing my story will have been worth it.

Until I started trying for a baby at 37 life had been going according to plan. I managed the acting and the travel parts of my goals, knocking on doors until they finally opened, and slowly climbed the career ladder.

I also met my decent man along the way –Ioan – who did, unbelievably, turn out to love me as much as I loved him.

As soon as we’d established that we both felt the same way, we got straight down to the exciting process of making the hordes of babies we both knew we wanted.

Actually I just made that bit up. Of course we didn’t.

Acting jobs are like buses – none come and then three arrive all at the same time, usually shooting on opposite sides of the world.

Finding the time to chat on the phone becomes complicated, let alone finding time to… well, you know what I mean.

There’s never a right time to breathe that long sigh of relief that says: ‘I think I’m ready now.’

We were delusional about a woman’s dwindling chances of getting pregnant after 35. That’s not anti-feminist, by the way – it’s just the plain truth.

The whole of my 38th year was spent reading studies about fertility, taking my morning temperature, planning ovulation graphs, standing on my head after sex, and fastidiously avoiding tea, coffee, alcohol, pineapple pizza and anything else I’d read about that might possibly prevent pregnancy.

Each month I excitedly ran to the bathroom at least five days before my period was due with a white stick in hand, and waited, my heart beating practically out of my chest for that second little red line to come up. And each month it didn’t.

I went to acupuncturists who told me they could ‘revitalise my eggs’ (b******t), a dietician who told me to cut out dairy (even worse – one of the best long-term studies ever done shows drinking one to two glasses of whole milk a day correlates with higher pregnancy rates).

Well-meaning but ill-informed friends swore I just needed to ‘relax’, which, when you’re trying to quell a rising panic, is kind of ridiculous.

Months went by but it seemed like years. I didn’t have a clue what to do or where to turn.

Mum had passed away unexpectedly a few years earlier and Dad had a new wife and new kids. My best friends had all done the sensible thing and had their children in their early 30s.

Then one day I found myself reading The Stork Club, Imogen Edwards-Jones’ brilliant account of her struggles with infertility.

Next thing I knew I was on the phone to her, sobbing uncontrollably; she understood and told me: ‘Alice, go see a doctor. A real doctor.’

Six days later I found myself lying on a padded table with a large piece of tracing paper over my naked bottom half, while a doctor slid a probe the size of a small rolling pin into my nether regions to look at my ovaries.

The blood tests had already revealed that my healthy eggs were few and far between, but this test – the antral follicle count – was the clincher.

Fifteen follicles (indicating the possibility of 15 eggs) was more or less what the doctor was expecting for somebody of my age.

Ten follicles would be about the lowest he’d need to do an IVF cycle with a decent chance of success.

We stared a big screen on the wall that showed my magnified uterus and watched open-mouthed as he started counting the black holes that represented my follicles. I had eight.

It became a journey of decisions. A round of IVF would cost upwards of £7,000 and we had about a 20 per cent chance of success.

I’d also mistakenly bought into the myth that the world is full of orphanages with lots of unwanted babies desperate for childless couples.

In fact, the waiting list to adopt a baby from China turned out to be upwards of five years. The average expense is about £35,000.

Adoption in the US is probably worse, full of hidden fees, false promises, lawyers and shady agencies, and the simple fact is this: there are many more desperate childless couples than there are babies who need them.

Adopting was more expensive and even less likely to succeed than IVF. So there we were – £7,000 and a 20 per cent chance of winning. Take it or leave it. We took it. And we won.

Seeing a faint red line one Saturday morning after I’d decided in my head the IVF cycle had clearly not worked was one of the most breathtaking moments of my entire life.

Ioan didn’t believe it. He said I’d been staring at it for so long that I was seeing things that weren’t there.

The next day there was a slightly darker line (we’re still talking shades of snow here) and the next one looked like it might be pink… until finally there it was. A second red line, staring back at me, unmistakeable.

Extremely high blood pressure earned me total bed rest for the last two months of the pregnancy and then there I was, in a hospital bed, sweating and screaming and writhing about – just like on television.

A mere 40 hours later Ella arrived, a 6lb 2oz lobster-red baby-alien.

Instantly none of my other plans mattered. This was the thing I should have done years ago. The only thing.

It was as close to being in heaven as I’d ever get. Neither of us had any doubt about the fact we wanted a second child, yet, despite what we had just been through, the luck of being part of that 20 per cent went to our heads and we thought it was OK to wait a year before starting the whole IVF process a second time.

This time our first cycle failed. As did our second. Our third didn’t even produce any eggs to fertilise. Our fourth gave us a few to freeze.

It wasn’t working. Finally, physically, mentally (not to mention financially) depleted, we decided sadly that cycle eight would be our last.

Elsie Marigold Evans-Griffith was born on September 13, 2013. She has her dad’s big brown eyes but not his unfeasibly long tongue, thank goodness.

I’m writing now because if we’d started trying even three years earlier we might have avoided everything I’ve just told you about.

I know how lucky I am. I won the lottery. I get to kiss goodnight to the two most precious human beings I’ve ever met.

My goal now is to get the word out. Don’t wait until it’s too late.

As for Shaky – I guess some things just aren’t meant to happen…

Counsellor: My early experience in a Fertility Centre

Lets Talk-01

I am a Registered & Licensed Counsellor.
I have just joined the TMC Fertility Centre about a month ago. Frankly, I have never experienced infertility nor have I been professionally exposed to any fertility treatment. Therefore, my 1-month of “befriending” infertility has been filled with lots of discoveries and learning, some are rather shocking while some are very inspiring.

What I find shocking and probably challenging for the patients to cope with is the financial burden it puts on young couples, psychological and physical burden of the IVF treatment itself and the fact that pregnancy is not guaranteed. Looking at it rationally, fertility treatment is just like any other medical treatment. There are so many uncertainties involved at every stage of the treatment cycle. The anticipation for favourable results after each medical procedure during the treatment cycle must be mentally “torturing”.

What I find amazing and inspiring:

  • I have the privilege of observing the work of the embryologist in its sophisticated laboratory. I am just simply fascinated by such advanced technology where the embryologist can view and count the number of eggs retrieved from the ovary of the patient, and the embryologist can actually catch a sperm using a special needle before bringing it to an egg to facilitate fertilization.
  • The exhibition of great patience and perseverance in the couples, particularly the wives, are simply remarkable. Some of our Fertility Specialists have vast experience in this area with a good track record of helping couples to conceive, thus they are very popular with many childless couples wanting to seek treatment from them. As a result, their appointments are usually full stretching from morning till late evening. I have seen couples who are willing to wait for as long as it takes, or to accommodate their schedules, just to meet these doctors, in hope of finding a solution to conceive.
  • During some of the counselling sessions, I was able to witness some beautiful moments where the husband expressed appreciation towards his wife for her  effort and pain endurance during the fertility treatment, where the husbands reiterated that they have never blamed their wives for not being able to bear a child when the infertility is due to woman factor or when the wives acknowledged having supportive husband and very understanding parents and parents-in-law for not asserting pressure regarding being pregnant. These moments of acknowledgement are lovely and important to build a strong emotional bond between the couples; unfortunately they do not happen often.

These are just some of the significant reactions that I experienced during my first month at TMC Fertility Centre. I am aware that there are many other emotionally challenging moments for the couples undergoing fertility treatment. There are anticipations, uncertainties and perhaps relationship issues resulted from infertility. The most impressive thing is that despite all these challenges, the human spirit perseveres. They live on and feed on the hope that one day they will be parents, and the strength the patients display is often the most amazing thing of them all and it is something that I get to witness here everyday.

Choy Xue Min is a Registered and Licensed Counsellor with TMC Fertility Centre, Kota Damansara. Previously, she was working as a Counsellor with an established private organization that provides counselling services and corporate trainings.
Xue Min obtained her Master degree in Counselling Psychology from Universiti Kebangsaan Malaysia (UKM) in year 2009. Subsequently, she became certified as a Trainer for the Journey to Intimacy workshop by Dr Huang Wei-Jen from Northwestern University, USA and a Trainer for Mental Health Facilitator Program by the National Board for Certified Counselors, USA.  She has also attended various courses including Working with Survivors of Child Sexual Abuse, The Education & Intervention of Intimate Relationship in School and Individual and Group Crisis Intervention by International Critical Incident Stress Foundation.
She is passionate in helping couples and family to maintain a harmonious relationship. She believes in the benefits of self-awareness through mindfulness concepts and encourages assertive communication in any form of relationship. Besides the conventional talking therapy, she may use expressive arts as part of her counselling intervention.

Xue Min can be contacted at counsellor@tmclife.com to answer any concerns or questions that you might have about the treatment of infertility. Your questions will be published anonymously in the “Let’s Talk” segment of this blog.


By Dr. Liza Ling

Polycystic ovary syndrome (PCOS) is a common endocrine system disorder that occurs among women of reproductive age. Women with PCOS do not ovulate regularly and this is could be responsible for 70% of infertility issues in women who have difficulty ovulating.

The exact cause of PCOS is unknown, however early diagnosis and treatment along with healthy lifestyle modification may reduce the risk of long-term complications, such as type 2 diabetes, high cholesterol, high blood pressure and heart disease.

There is no single test to diagnose PCOS. To be diagnosed with the condition, you will need to fulfill at least two of the followings:

  • Irregular menstrual cycles. This is the most common presentation with menstrual intervals longer than 35 days; less eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
  • Excess androgen. Onset of excess facial and body hair (hirsutism), acne, male-pattern baldness (androgenic alopecia) due to elevated male hormones.
  • Polycystic ovaries. The ovaries are enlarged and contain many small cystic structures, about 2-9mm in diameter.


A woman with PCOS often does not have regular menses. This also means she does not ovulate monthly, hence the difficulty to conceive. Hormone pills like birth control pills can help in regulating the menses but will also prevent a woman from getting pregnant. Therefore, can women with PCOS conceive? The answer is yes! The chance of conceiving for women with PCOS using fertility treatments is good.

As a first step, a change in lifestyle is imperative, through low calorie diet combined with moderate exercises. PCOS is often associated with excessive weight. A modest reduction in weight, for example losing 5% of body weight may improve the regularity of menstrual cycles and thus higher chance of getting pregnant.

Even though anovulation may be the main cause of infertility in women with PCOS, other causes for infertility in a couple should be ruled out before embarking on the use of fertility medications.

There are many fertility medications available. The options are:

  • Clomiphene citrate (Clomid) is an oral anti-estrogen medication. It is the first line medication that will help to induce ovulation and is usually taken in the first part of menstrual cycle.
  • Metformin can be combined with clomiphene citrate to improve chance of ovulation, especially in women who are resistant to clomiphene citrate.
  • Letrozole (Femara) is an aromatase inhibitor which is also effective in inducing ovulation.
  • Gonadotrophins- follicle stimulating hormone FSH) and luteinizing hormone (LH) are medications that are given by injections, and are usually used when women do not respond to clomiphene citrate. It carries a small risk of ovarian hyperstimulation and higher risk of multiple pregnancies as compared to clomiphene citrate.

When medicines do not work, some women may benefit from a surgical procedure called ovarian drilling which is normally performed through laparoscope (key-hole-surgery). It is as effective as gonadotrophins without the risk of ovarian hyperstimulation and multiple pregnancies. The disadvantage of ovarian drilling is that it is an invasive procedure.

In vitro fertilization(IVF) offers another option in treatment for women with PCOS and infertility. It gives the best chance of conceiving in any given cycle but it is costly.

There is no magical cure for PCOS. However, the chance of conceiving with medical help is good. It is best to discuss and work with your fertility specialist for the most favorable outcome.

Dr. Liza Ling Ping is a Consultant Obstetrician, Gynaecologist and Fertility Specialist in TMC Fertility Centre. Dr. Liza specialises in treating advanced reproductive disorders that include endometriosis, polycystic ovary syndrome, uterine fibroid tumors and ovarian cysts, congenital anomalies of the female reproductive tract – including müllerian duct anomalies and various hormonal disorders such as premature ovarian failure from chemotherapy or other causes.

The History of Assisted Reproductive Technology in Under 1000 Words…

I have been talking about hyper ovulation, embryos, blastocysts and science of human reproduction a whole lot this past week as one of my dearest friends is going through the IVF process. In one of our nightly chats she wondered aloud about the historic evolution of this technology and that inspired the thought in me that perhaps a post exploring this rather obscure historical topic was in order.

Between 1845 and 1849, physician J. Marion Sims started on the road to becoming arguably the most famous American surgeon of the 19th century and acknowledged as the founder of modern surgical gynecology by experimenting on enslaved African American women in Montgomery, Alabama. Sims artificially inseminated fifty-five infertile females slaves. He produced one pregnancy, though the woman eventually miscarried. Then along came Dr. William Pancoast, who in 1884 as a professor at Jefferson Medical College in Philadelphia consulted with a Quaker couple who were struggling with infertility. Believing the woman was capable of having a child and the man sterile he constructed an ethically questionable experiment where he inseminated the wife in the Quaker couple with the sperm of one of his medical students. The experiment resulted in the birth of a baby boy.

The next great stride in the field of assisted reproductive technology came in 1934 when Gregory Pincus, the man who would later gain fame for being the scientist who, funded by reproductive rights advocate Margaret Sanger and heiress Katherine McCormich, synthesized Enovid, the first oral contraceptive pill on the market. Pincus claimed that he had achieved in-vitro fertilization of rabbits in his Harvard laboratory. Pincus was instantly vilified in the national press for tampering with life and playing God. Due to the backlash Harvard did not grant Pincus tenure.

Starting in the 1950s, Dr. Robert Edwards, a physiologist at Cambridge University was working on isolating hormones in mice. One night in 1965 Edwards successfully created a human embryo by adding his own semen to a human ovum in a Petri dish. It was a Frankensteinesque moment. Edwards realized one of the greatest fears of those critical of scientific research into fertilization: a lone scientist, late at night, creating life in a lab. It is possible that Edwards feared the potential criticism, ostracism and religious condemnation he would receive if he went public with his finding so he destroyed the evidence and kept his research a secret until he found a research partner in one Dr. Patrick Steptoe who could help him take his work to the next level.

Patrick Steptoe was a gynecological surgeon practicing in a small hospital outside of Manchester, England in relative obscurity. Steptoe had access to something Edwards did not: human ova. The two joined forces and over the next decade the duo set about created the first human pregnancy through in-vitro fertilization. They needed a woman and her husband who suffered from infertility and would allow them to join sperm and egg in the lab and then insert the resulting embryo into uterus of the woman. Enter John and Leslie Brown.

John and Lesley Brown’s story reads like the plot of an independent BBC-funded film highlighting the quiet desperation of the British working class. The couple had been trying to have a baby for the better part of a decade. John worked as a bartender in Bristol and found part time work on the railroad. Leslie weighed and packaged cheese in a factory. Their relationship was strained by their failed attempts to have a child. Lesley’s fallopian tubes were blocked from uterine scarring. Lesley reportedly told John, “I’ve nothing to give our marriage now that I can’t have a child.” But John, who had a daughter from a previous marriage, stuck by her, and their physician referred them to Dr. Steptoe, who was doing something that seemed like science fiction to them.
When they met with Dr. Steptoe they were confused by his language and terms like fertilization and re-implantation. It may have all gone over their heads but they understood enough to know that Dr. Steptoe was offering them the possibility of a baby. Lesley reportedly told him that whatever he was offering she was willing to try. She said that at night she would pray, “Dear God, I wouldn’t moan about being kept awake at night and washing dirty [diapers] if you’d let me have a child.”

All parties went ahead with the procedure. A healthy egg was harvested from Leslie and a sperm sample was taken from John. Steptoe and Edwards introduced the two gametes in a Petri dish and then transferred the fertilized embryo into Lesley’s uterus. The embryo implanted and Lesley was pregnant.

Dr. Patrick Steptoe performed a Cesarean on Lesley Brown on July 25th, 1978 and the world’s first test tube baby, Louise Joy Brown, was born weighing in at 5 pounds, 12 ounces. News of the test tube baby had gotten out to the media during the last month of the pregnancy and reporters swarmed the tiny Oldham, England hospital. It was the dawn of a Brave New World where children could be created outside of the marriage bed.

It wasn’t long before IVF technology crossed the pond. The first IVF baby born in the United States was Elizabeth Carr in 1981 and since that time fertility clinics and cryobanks across the country have been creating and storing embryos. Since the introduction of these reproductive techniques more than 200,000 babies have been born in the United States alone and the technologies have spawned massive fertility industries in countries around the world, such as in India which boasts over 3,000 IVF clinics and one of the world’s top destinations for fertility tourism.

It’s a pretty impressive technological evolution to take place in just over 170 years. Imagine where the science will be in another 170 years and what the sociological trends in human reproduction will be as IVF and associated technologies allow couples to have children at later ages and to screen for genetic disorders.


Egg Freezing


Egg freezing, clinically known as ‘oocyte vitrification’, is a procedure where eggs are extracted, frozen and stored for use on a later date. The technique of vitrification involves flash freezing the eggs in a glass-like state without the formation of ice crystals. This method allows the eggs to sustain their original properties at the time of retrieval.

Why freeze eggs?

The number of eggs a woman produces in her lifetime is determined at birth. Her ovarian reserves and egg quality will begin to decline around 30-35 years of age. Egg vitrification helps to preserve fertility when the woman is younger and healthier, and is suitable for women who:

  • Are of childbearing age but is not yet ready to have children.
  • Have low ovarian reserves due to medical conditions.
  • Are due for aggressive medical treatments such as chemotherapy, radiotherapy, or surgeries for tumours.


What does the procedure involve?

Step 1: The woman first has to undergo controlled ovarian hyperstimulation with hormone injections for ten or twelve days. The hormones help promote and stimulate follicle growth in the ovaries which contains the eggs.

Step 2: During the stimulation phase, ultrasound scans will be performed every two to three days to monitor the progress of the follicle growth.

Step 3: Once the follicles reach the right size, a final injection is administered. This injection helps the eggs mature, enabling them to be retrieved after 36 hours.

Step 4: Egg retrieval or ‘Oocyte pick-up’ (OPU) is performed under sedation to avoid discomfort. Once retrieved, the number, quality and morphology of the eggs will be assessed before the vitrification process.

How are vitrified eggs used?

When the woman is ready for a baby, her eggs are first thawed. Around 90% of eggs that are thawed will survive the process.

Once the eggs are thawed, they are fertilised with the sperm of her partner or a donor using the Intracytoplasmic Sperm Injection (ICSI) technique. When embryos are formed, they will be incubated in the lab for 3-5 days before they are transferred into the woman’s uterus.

What are the advantages of egg vitrification?

Egg Vitrification allows a woman to:

  • Have biological children at a later date.
  • Decide when she wants to start a family without worrying about egg quality declining because her eggs will have the same quality and age of the time they were vitrified.
  • Have children using her own eggs after aggresive medical treatments that might inhibit fertility such as chemotheraphy, radiotheraphy, or autoimmune diseases which requires cytotoxic medications and treatments.

Facebook, Apple and Google has recently announced that they are willing to sponsor their female employees who want to freeze their eggs. This certainly has brought about a new perspective on giving women reproductive freedom.

Asthma may delay pregnancy, decrease birth rate


Asthma has been linked with a prolonged time to pregnancy and a decreased birth rate, says a study.

“The median total time to pregnancy was 32.2 months in non-asthmatic women and 55.6 months in those with asthma, the study revealed.”

Women with asthma also had fewer successful conceptions, the researchers said adding that the trend was more apparent as the women got older.

Only 39.6 percent asthmatic women achieved pregnancy compared with 60.4 percent in the women without asthma, the findings revealed.

“This finding in a clinical trial setting adds new weight to the epidemiological evidence suggesting a link between asthma and fertility. We have seen here that asthma seems to have a negative influence on fertility as it increases time to pregnancy and even more so with age,” said lead author, Elisabeth Juul Gade.

Clinicians should encourage women with asthma to become pregnant at an earlier age and optimise their treatment for asthma pre-conception, suggested the researchers.

The study adds to previous studies that have identified a link between asthma and fertility. The evidence so far has been conflicting and many of the studies have either relied on data from questionnaires or small sample sizes, the researchers pointed out.

The current study, published in the European Respiratory Journal, investigated 245 women with unexplained fertility problems aged between 23 and 45 years, they added. The women underwent asthma and allergy testing and questionnaires during their fertility treatment.

As many as 96 women in the study had either an existing doctor’s diagnosis of asthma or were diagnosed with asthma when they entered the study, the researchers revealed.

The researchers monitored the women during their fertility treatment for a minimum of 12 months, until they had a successful pregnancy.


Pelvic inflammatory disease caused by STDs – chlamydia and gonorrhea – can increase the risk of infertility in women


Pelvic inflammatory disease caused by sexually transmitted diseases (STDs) such as chlamydia and gonorrhea can increase the risk of infertility in women. If STDs are left untreated, they can result in pelvic inflammatory disease (PID) – a serious condition, which causes infertility in one in eight women. PID can be prevented, thus reducing the risk of infertility and other complications associated with pelvic inflammatory disease.

Pelvic inflammatory disease causes

Pelvic inflammatory disease is caused by sexually transmitted diseases. A PID is caused by either an untreated STD, having more than one sexual partner, having sex with a partner who has had numerous partners, having a history of PID, being sexually active under the age of 25, douching, or using an intrauterine device (IUD) as a method of birth control.

You can lower pelvic inflammatory disease risk factors by being in a long-term monogamous relationship with a person who has been negatively tested for STD, and using latex condoms correctly.

Pelvic inflammatory disease symptoms

There is currently no test specific for PID, but your doctor can diagnose it based on your signs and symptoms, along with medical test results. Symptoms of PID can range in severity from fairly mild to quite severe. Symptoms associated with PID include:

  • Pain in the lower abdomen region
  • Fever
  • Unusual discharge followed by a bad odor from the vagina
  • Burning sensation when urinating
  • Bleeding between periods

These symptoms may overlap with a urinary tract infection – another health issue which can lead to complications if untreated – and so it’s important you see your doctor to distinguish between the two.

Pelvic inflammatory disease treatment

If caught early, PID can be cured. But if damage has occurred, unfortunately, it cannot be reversed through treatment. The longer PID goes untreated, the more damage can occur to the reproductive system, ultimately leading to infertility.

Antibiotics can be prescribed and should be taken until completion, even though the symptoms may have gone away. If your partner has an STD, they also should receive treatment in order to prevent future occurrences of PID.

Complications of PID include:

  • Scar tissue formation inside and outside of the fallopian tubes, which can block the tubes
  • Ectopic pregnancy – pregnancy outside of the womb
  • Infertility
  • Long-term pelvic and abdominal pain

If you begin to experience any of the symptoms listed above, speak to your doctor immediately, so treatment can begin right away in order to reduce your risk of complications associated with PID.


Japanese woman has baby through egg freezing, defying expert guidance


A Japanese woman in her 40s gave birth to a baby last year using her own frozen egg, an Osaka fertility clinic said Tuesday.

It is believed to be the first time in Japan that a healthy woman has chosen to use a preserved egg to conceive. There have been other cases where cancer patients have given birth using eggs that were frozen for later use to avoid the infertility risks that come with undergoing radiation therapy.

In February last year, an expert panel from the Japan Society of Obstetrics and Gynecology (JSOG) said it would not recommend that young and healthy women preserve their frozen eggs for future pregnancy, citing health risks for the women as well as the relatively low pregnancy rates for the procedure.

The woman, a 44-year-old nurse from Osaka Prefecture who had her eggs frozen on several occasions before her marriage, thawed the eggs in 2014 and became pregnant through in vitro fertilization (IVF) using her husband’s sperm, according to a fertility clinic in the city of Osaka.

She gave birth to a girl last year, according to the clinic that treated her, Oak Clinic, Sumiyoshi.

Medical institutions in Japan are not obligated to report to the JSOG a case in which a healthy woman gives birth using a frozen egg.

The clinic started the egg freezing program for healthy women in 2010 and had preserved eggs of some 230 women by the end of last year.

The nurse is the first who gave birth among 17 patients who had IVF treatment using frozen eggs at the clinic.

“We would like women to know (the program) is an option when they think about pregnancy and childbirth, while we do not necessarily recommend having a child in the later stages of their lives,” said Miyako Funabiki, a doctor who was in charge of the woman’s case at the clinic.

Ran Kawai, a journalist known for her reporting on childbirth issues, said, “It is an unavoidable trend that women will choose births through egg-freezing programs as more women fully participate in society now and balance work and childbirth.”

But Kawai also said it is a priority to “develop a climate to encourage women to give birth at safer ages.”

Egg freezing, or oocyte cryopreservation, involves the process of growing multiple oocytes by use of internal medicine and injections, or by not using ovulation induction at all, but by collecting the oocytes and preserving them in liquid nitrogen.

After thawing, the eggs can be fertilized through IVF before being implanted into the uterus wall.

Oocyte cryopreservation previously posed a large challenge compared with freezing sperm or fertilized eggs. But advancement of technology since the late 1990s has allowed egg freezing programs to spread around the world as a form of fertility preservation.