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2nd August, 2010
KOTA KINBALU: If you and your partner are having trouble conceiving a child, seek help early. “Go for early investigations and diagnosis – don’t wait until you’re 45 when you could have gotten help 10 years ago,” said British fertility expert Dr Steven Fleming.
A woman’s pregnancy rate falls after the age of 35 which is why many infertility specialists encourage couples to act quickly when the female partner is already in her early thirties, said Dr Fleming. According to him, the sperm DNA also damages with age.
Dr Fleming, the scientific director of Assisted Conception Australia (ACA) – a fertility centre he founded in Brisbane in 2008, was in Kota Kinabalu recently to give a talk called “Are You Trying To Have a Baby? Your Questions Answered” at a public forum held at the Pan Pacific Sutera Hotel.
For many couples who are unable to have a child, treatment for male and female infertility are available where eggs and sperm are prepared to provide better chances of fusing and fertilizing leading to the formation of an embryo and a healthy pregnancy in the womb.
In vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are the two common techniques available from a wide range of treatments collectively known as ‘assisted conception’ or Assisted Reproduction Technology (ART).
IVF – the original ‘test tube baby’ technique – removes several eggs from the ovary, fertilizes them in the laboratory with the partner’s sperm and transfers a small selection of the resulting embryos to the womb for implantation and pregnancy. The success rate for IVF technique per treatment cycle is typically 25% to 30%, said Dr Fleming. The world’s first test-tube baby, Louise Joy Brown, celebrated her 32nd birthday in the United Kingdom on July 25 last Sunday and now has children of her own.
Dr Fleming said the ICSI technique is just as good – it achieves fertilization with just one sperm cell injected into an egg and this method offers a viable treatment for even the most difficult cases of male infertility. “IVF has 71% fertility rate compared to ICSI which has 66%. IVF has also a lower fertility failure rate of 2.6% versus 2.0% in ICSI.” he said.
“Theoretically, a couple can have unlimited cycles of ICSI or IVF provided they’re still producing eggs or sperm although treatments can be limited by the woman’s age,” he said.
Treatment of infertility by IVF is available at the IVF Centre since its establishment at the Sabah Medical Centre (SMC) in 2006. In 2007 SMC produced its first ICSI baby in Sabah who is also the second IVF baby delivered at the medical centre.
A range of other options are also available at the centre to assist conception, depending on the diagnosis and type of infertility. Procedures include ovulation induction (with fertility drugs), gamete intrafallopian transfer (GIFT), intrauterine insemination with or without superovulation (IUI), and ICSI.
SMC carries out investigations and treatments that might help couples before they embark on assisted conception. A specialist conducts investigations to ascertain the likely cause of infertility and tests for determining a specific cause that assess ovulation, quality of the fallopian tubes and hormone levels in women, as well as sperm production in men. The centre also offers counselling for couples undergoing assisted conception.
Dr Fleming said a poor environment can be damaging to embryo development and a good laboratory is vital for proper embryo development and maturation in order to obtain good quality embryos. “A controlled environment is necessary to prevent volatile organic compounds from getting into the lab, such as car fumes, paint fumes, fumes from glues. We can prevent this by keeping the lab at a higher air pressure than the surrounding areas so air never enters but only leaves the lab, or control the type of air coming into the lab by using carbon filters.” he said.
There are of course, risks of assisted conception. The risk of a baby having cerebral palsy increases five folds for twins compared to a ‘singleton’ baby, according to Dr Fleming. “Other risks include miscarriage, low birth weight and other range of mortalities if a woman is carrying twins or worse still, triplets.”
However, the chances of having twins or triplets if a single embryo is transplanted are ‘very very low’ at around 1% or less, according to the doctor. “The trouble is when you transfer two embryos your chance of getting twins increases up to 20%; likewise chances of having triplets go up if three embryos are transplanted.”
Dr Fleming said sometimes the best thing couples can do is have sex regularly to increase their chance of conceiving a child. “When couples try frequently the male partner’s sperm would have been produced in the best possible condition as well as help to increase the number of opportunities for eggs to be fertilized,” he said.
Sabah Medical Centre is located at Lorong Bersatu, Off Jalan Damai, Luyang. For more information on infertility treatments at SMC, call 088-211 333 or fax 088-272 622 or visit www.sabahmedicalcentre.com. Alternatively, go to www.fertilityjourney.com.my to find out more about assisted conception. “Are You Trying To Have a Baby? Your Questions Answered” was sponsored by Merck, Sharp & Dome (MSD).
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