Genetics, congenital conditions
CAUSES: Low sperm count or quality; Premature reduced ovarian reserve in daughters of consanguineous unions (marriage between close blood relatives).
Dr Robertson says his clinic addresses many cases of men with very severe sperm problems. “Some men don’t have any sperm in their semen in a regular sample. It might be there’s a blockage or because the number of sperm produced [is low]. It’s a common problem in this part of the world, among the local population in particular.”
SOLUTION: A procedure called Micro-TESE is performed on men which probes testicular areas where sperm production is active and retrieves them microscopically. For women, genetic testing is needed for blood-related would-be couples to avoid the risk of consanguineous unions.
Age
CAUSES: Delaying marriage and delaying motherhood due to lifestyle choices and pursuing careers can have a negative impact on a woman’s fertility. A woman is born with a fixed supply of eggs in her lifetime. By the time she gets to her late 30s, early 40s, the supply decreases.
“Age is the single most important factor in the woman’s ability to conceive. It’s downhill all the way from 25,” Dr Robertson said.
“Over the age of 35, it becomes significantly more difficult because a woman has a reduced supply of eggs and secondly, the eggs that she does have have been waiting for longer (to get fertilised). So, if you like, the genetic material gets a bit scrambled and they’re more likely to have genetic problems.”
SOLUTION: Marry at a younger age and have your babies younger. “You can’t fight biology; you can, to some extent, help. But at the end of the day, that’s the most important factor.”
Underlying or pre-existing conditions
CAUSES: Diabetes and other disorders like Vitamin D deficiency and thyroid disease are common in this region. For women, the common cause is cysts in the ovaries and tubal defect or blocked tubes resulting from tissue build-up or scarring from a previous untreated infection.
“There’s one particular condition called polycystic ovaries, which is particularly common among Arab women, Indian women, and some other populations. It’s difficult to say why it happens - there might be a genetic basis to it - but it’s due to malfunction of some of the hormones that control the ovaries,” Dr Robertson says.
SOLUTION: Managing diabetes through proper diet, exercise and medication is key. For women with tubal defects or blocked tubes, IVF is usually an alternative if the tubes are totally damaged. If the blockage can be surgically removed, and everything else is normal, natural conception can occur.
For women with polycystic ovaries and thyroid issues, medication, diet and lifestyle changes are needed. Dr Alonzo says traditional Chinese medicine can help best. “We help women with polycystic ovaries to regulate their periods and to get pregnant. But if the tubes are blocked, there’s nothing we can do.”
Diet, lifestyle and clothing
CAUSES: Smoking and drinking too much alcohol.
“A woman who smokes has ovaries that are 10 years older than her actual age. It’s really toxic for the ovaries and the sperm,” Dr Diana Kayal, OB/GYN and Reproductive Medicine at Bourn Hall Clinic, said.
SOLUTION: Quit smoking and stop drinking too much alcohol. Couples should also maintain a normal body mass index of under 30 and not be overweight.
CAUSES: Unhealthy eating habits; wearing tight clothing for men.
Dr Alonzo says about 70 to 80 per cent of the women they see at the centre have what they call blockage of blood and energy flow, of which 90 per cent is due to lifestyle. This lack of good circulation affects reproductive organs and other parts of the body. This manifests through hands that are usually freezing cold, even a bit sweaty. The individual is easily irritable and gets angry easily. She’s hyper, nervous, always running around, cannot relax, and cannot sleep well and deeply enough.
SOLUTION: Body imbalance can be restored by improving the blood and energy flow through acupuncture and herbs. The right type, and temperature of food, also helps, says Dr Alonzo.
Stress
CAUSE: A study published in the journal Human Reproduction in March this year revealed that women with high stress levels are 29 per cent less likely to get pregnant each month compared with those who have low stress levels. They also have more than twice the likelihood of being declared infertile.
Dr Kayal says stress mainly comes from the couple’s environment — at work and their social circles, especially pressure from the family. “It is well recognised that you need to lower your stress level to be able to conceive and live through a stressful period of your life when you’re undergoing fertility treatments because it’s not easy actually.”
About half of the cases Dr Alonzo sees at the centre are due to stress and imbalance while the other half have underlying medical conditions.
SOLUTION: Alternative options are available to beat stress such as yoga, meditation, moderate exercise, and sports.
“We can’t change the situation but we can change our body’s response to that,” Dr Alonzo says. “By using herbs and acupuncture, it will change the body’s response. The body becomes more resistant to [stress]. As a result, you feel better about yourself.”
