Most married couples look forward to have children of their own but some are less fortunate, being childless even after years of marriage.

Infertility becomes a problem for married couples in realising an important goal in their life, that is to have children of their own, and some may attribute the situation to fate, for lack of any other explanation.

Unfortunately, spouses have been known to blame each other for the problem.

Dr Surinder Singh, obstetrician, gynaecologist and fertility consultant admits that awareness about infertility and the available treatment is still low in Asia.

AGE FACTOR

"Many of the risk factors for infertility in both males and females are the same. About one third of infertility cases are caused by problems attributed to the women while another third concern the men.

"Other cases are caused by a problems that could be in either sex, or whose origins could be unknown," Dr Surinder explained, adding that the risk factors are closely linked to the couples lifestyle.

Age is certainly a factor contributing to the risks that could lead to infertility.

For a woman above 30 years of age, her fertility potential gradually declines while men older than 40 may be less fertile than those younger.

SMOKING, EXCESSIVE ALCOHOL CONSUMPTION

Smoking and excessive alcohol consumption reduce a couples chance to achieve pregnancy.

Furthermore, for women, there is no safe level of alcohol consumption during conception or pregnancy.

"Excessive alcohol consumption increases the risk of birth defects and it may also make it more difficult for a woman to conceive," Dr Surinder said.

Being overweight or underweight as well as excessive exercise may also cause infertility.

TESTS

Couples associated with infertility need to go through an evaluation procedure in order to identify the root cause of the infertility problem.

Those with fertility problems are encouraged to go through such an evaluation if they are older than 35 years of age.

"Normally, the female spouse will also have an irregular menstrual cycle. There are a few tests in this evaluation procedure to identify the problem for both spouses.

"Tests available include the general physical examination, hormone testing and semen analysis for the man while the woman can be diagnosed after going through the ovulation testing, a Laparoscopy, hormone testing and a pelvic ultrasound," Dr Surinder went on to explain.

In the general physical examination, questions concerning the patients medical history, illness and disabilities, medications and sexual habits will be asked after a thorough physical check is done.

An analysis of a semen sample will provide a picture about the quantity, colour and presence of infections or blood.

All these tests will help the doctor determine whether the man is producing enough healthy sperms.

For the woman patient, the ovulation test is carried out to measure hormone levels and this can help determine whether the woman is ovulating.

Besides that, the Laparoscopy, which is performed under general anaesthesia, can be done to examine her fallopian tubes, ovaries and uterus.

"The Laparoscopy can determine whether a woman is releasing healthy eggs regularly, and if her reproductive tract allows the egg and sperm to pass into her fallopian tubes," he said.

Dr Surinder is the Malaysian Society of Assisted Reproductive Technology, (MSART) president.

HOPE

MSART, supported by pharmaceutical company Merck Serono, had recently launched the Hope for a Child campaign.

The campaign is on a programme that takes a holistic approach in benefiting infertile patients.

Besides creating awareness about infertility by offering guidance and information on the treatment options available, the programme is aligned with efforts to shed light on the subject which is considered taboo and seldom discussed.

The cost of treatment may be high for many but this programme sees couples who were unsuccessful in their first course of treatment via the In Vitro Fertilisation (IVF) method getting some assistance regarding their next course of action.

These couples must have completed their first paid IVF treatment cycle under the 'Hope for a Child' campaign and the IVF treatment is only applicable and suitable for couples with a normal sperm count.

There are other treatment options like the Intra Cystoplasmic Sperm Injection (ICSI) which would be of bigger benefit to couples with sperm problems.

Besides, there is also the Gamete Intra Fallopian Transfer (GIFT) treatment for infertility which employs use of an older technology but this method is less popular compared to the IVF method.

More information is available at www.fertilityasia.com.my.