Congratulations, You Are Now Married! What’s Next?

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By Dr. Chong Kuoh Ren

Getting married is one of the biggest commitments you will make in a lifetime. After the flurry of the wedding has died down and you have settled into a new routine, the realities of married life will begin unveiling themselves. One of them will surely be about having children.

While having children will spell further commitments in terms of time, finances and energy, the pitter-patter of little feet can be a great source of joy. Watching your little one grow and teaching him or her about life is also an enriching process for you as a couple and you child.

Some couples may feel they are not prepared to have children, preferring to enjoy a prolonged honeymoon until later when they are ready financially and emotionally. The question is, how ready is ready?

Until you get a promotion? Finish furthering your education? Buy your own house? Finish your car installments? Or until you feel you can cope with the responsibilities of caring for another life apart from your own?

It is a false notion that a couple needs RM1 million in the bank before having children. While it is not wrong to be prepared before you begin a new (and lifelong!) journey of parenthood, waiting too long may not be advisable.

Consider these:

  • Having a baby and bringing up a child together will create an inseparable bond with your spouse. This will invariably strengthen your marriage.
  • The older you are, the less healthy your eggs and sperm become. Women in particular should start a family before the age of 35 while she still has decent ovarian reserves.
  • Eggs and sperm quality is less optimum as you age. The risks of miscarriages, stillbirths or birth abnormalities also increase from 30 years of age.
  • It is easy to lose track of time; and one year of ‘taking it easy’ may become five or ten years before you realise it.

Without the use of family planning methods, a healthy couple should conceive naturally within one year of unprotected intercourse. When that does not happen, it would be advisable to check the reproductive systems of both spouses to find out what is wrong.
Even if you are not ready to conceive, women (at any age) may want to get a gynaecologist or fertility doctor to check their ‘fertility health’ , i.e. any structural problems of the womb (fibroids, polyps), tubes (blockage) and ovaries (cysts) and ovarian reserves (number of eggs left). Early identification of potential problems means steps can be taken to plan your future pregnancy timetable.

Note: Dr. Chong Kuoh Ren is an Obstetrician & Gynaecologist and Fertility Specialist at the TMC Women’s Specialist & Fertility Centre Puchong ( For more enquiries or to schedule an appointment, please call: +60 3 6287 1000 or email us at

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

Let’s Talk Eggs

Time stops for no man or woman.  This is especially true for our eggs as age impacts negatively on both the number and quality of eggs that women have. Women may want to put their fertility on hold for personal reasons or may want to preserve their ability to have a biological child in the face of a cancer diagnosis which involves chemotherapy or radiation to her pelvis.

Dr Hoo Mei Lin, Consultant Obstetrician & Gynaecologist and Fertility Specialist from TMC Fertility Centre Kota Damansara, shares with us her thoughts and views on egg cryopreservation. “A woman is at her most fertile between the ages of 20-35.  If we are busy living life, pursuing our dreams and careers, this may mean that when a woman is ready to start a family, she may experience difficulties conceiving as our fertility reduces quite drastically after 35. Many women face the unenviable decision. Do I put my dreams on hold? Do I settle for Mr Right Now or do I wait for Mr Right? Will I be able to have kids later?” says Dr Hoo.

Wouldn’t it be great if we can stop time? 

Science has now made it possible to do just that.  Egg cryopreservation or egg freezing could be your answer.  “Freezing your eggs when you are at your peak in your fertility will mean that when you aim to get pregnant at a time of your choice, you will still have eggs at its optimum.  The process involves 2-6 weeks of injections to stimulate egg production. The primary goal is to freeze 15-20 eggs for each baby you plan to have. The eggs are then vitrified and then frozen. You may experience bloating and cramps during the whole process. The procedure is not cheap but then again, what is the price you would put on ensuring your fertility?” explains Dr Hoo.

While egg freezing does not guarantee a baby, it is certainly a reliable insurance plan. Aren’t the experts always saying one should not ‘put all your eggs into one basket’?

Dr Hoo Mei Lin is a Fertility Specialist at TMC Fertility and Women’s Specialist Centre Kota Damansara. For more enquiries or to schedule an appointment, please contact +603 6287 1000, visit or email

Not abnormal, just different

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By Dr Liza Ling Ping,

Consultant Obstetrician & Gynaecologist and Fertility Specialist

Puberty is when many young girls notice changes in their body. This normally occurs between the ages of 10 to 14 years old. Although puberty is the natural life transition from childhood to adulthood, many young girls are uncomfortable discussing it openly.

If adult women are apprehensive consulting a gynaecologist for their ‘female’ problems, just imagine how young girls would feel when they face problems with puberty changes or gynaecological issues. Gynaecological problems in adolescents and children are different from that of adults, therefore the approach needs to be knowledgeable, skillful and tactful to ensure patients and parents feel safe and comfortable.

In younger girls between 12 months and 4 years old, labial adhesion and vulvovaginitis are the most common cause for parents to bring their child to see  a doctor. Labial adhesion and vulvovaginitis are common conditions and easily treated.

For adolescents, many girls seek help with heavy or painful periods. Some may experience irregular periods, especially in the first 1-2 years after menarche (first menstrual bleed). Girls should also seek help if they experience primary or secondary ammenorrhoea (absence of a period or if the period suddenly stops).

Sometimes parents are concerned when their child have delayed menses or delayed development of secondary sexual characteristics (eg. breasts and pubic hair development).  If by 14 years old, your daughter has not shown any secondary sexual development or has not had her period by 16, it could be a sign of developmental issue. Menstrual irregularities should be diagnosed and addressed early to prevent complications such as infertility, anaemia (lack of blood) and heamorrhage (excessive bleeding).

More complex conditions such as precocious puberty, abnormality of the genital tract- eg MRKH (absent uterus), OHVIRA syndrome, or disorders of sexual differentiation-eg androgen insensitivity syndrome (AIS), Sywer syndrome requires great knowledge and understanding in order to help both patients and families understand the conditions. Patient and parents also need to be reassured that their lives can be enjoyed and not let these conditions discourage them.

Sometimes, parents will request to stop the menses of their daughter completely, in cases of developmental delay or cerebral palsy. This can be done using reversible treatments such as Mirena IUCD or other medications, until they are able to cope with menses, thus giving both parents and the adolescent some peace of mind.

It is important to be open with your children so that they are comfortable talking about what is happening to their bodies and about any symptoms they may experience. Most of the conditions are treatable.

However, these symptoms are best addressed at an early stage, so as not to miss the opportunity for counselling and early intervention to help adolescents understand that they are not abnormal, just a little different.

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.


My Fertility Journey [Part 12]


He’s here!

It’s been a week since our little man arrived, and wow, nobody was joking about all the sleepless nights.

Labour was intense and terribly painful, and nothing compared to the bout of Braxton Hicks I got hit with earlier.  But a little support can go a long way and I’m so thankful Adam was by my side. I don’t know how I would have gotten through those ten excruciating hours without him, let alone not go into a panicking frenzy when my water broke while I was grocery shopping! But that’s a story for another day. Maybe when I’ve clocked in more than two hours of sleep a night. Though I doubt that will be anytime soon.

Hearing that little cry at the very end of all the pushing was the most relieving thing the both of us has ever heard.

We’re all in recovery mode now. Well, except Daniel. He seems to be just as excited about finally being in the world as his mommy and daddy are about him too.

The names of the characters in this article has been changed to protect the privacy of the original person

My Fertility Journey [Part 11]


What are the chances?

After checking in with you guys last, I went into labour – or at least I thought I was going into labour.

As it turned out, I had a case of Braxton Hicks. I’m a rookie, so obviously, I went into panic. I was in the middle of my morning walk when it happened. I rushed to see my doctor and he confirmed it: false labour.

I’m home now and resting, just as the doctor ordered.

Part 10 Here!

The names of the characters in this article has been changed to protect the privacy of the original person.

My Fertility Journey [Part 10]



Hi guys!

Time really does fly, huh? The last nine months have been a rollercoaster ride for me. So, I’m really sorry if you haven’t heard from me in awhile. There have been mostly good days, and some bad ones. But that’s what makes pregnancy such a life changing experience, isn’t it? You begin to learn things about yourself that you never knew before. You discover new strengths and make peace with old weaknesses. You come to terms that this is the beginning of a new version of the rest of your life.

I’ve enjoyed every moment of my pregnancy. Even the painful, nauseating ones. But I’m anxious and excited to finally meet the tiny person I’ve been carrying around inside me all this while. Though if there’s one other person who’s more excited than me, it’s Adam. He’s been on a thorough hunt for all things Ferrari for our little one. I can’t say I’m 100 per cent for our boy being a Formula 1 driver just yet. Maybe if he agrees to be in onesies till he’s eight? I’m kidding.

I have a feeling I’m going to miss this whole experience. From the cravings and not feeling guilty about giving into them to seeing my little tot grow inside of me, feeling him kick around and stretch. It’s like he’s almost hinting he cannot wait to come out. I guess it’s true what they say: enjoy every moment while it lasts.

Part 9 Here!
The names of the characters in this article has been changed to protect the privacy of the original person.