The Star Malaysia

Too shy to ask?

Here are eight questions about in-vitro fertilisat­ion (IVF) that you may be too embarrasse­d to ask your doctor.

- By Dr AGILAN ARJUNAN

FERTILITY problems are not the best dinner conversati­on topics as they involve intimate issues that usually occur behind closed doors.

That is exactly why you should feel free to speak to your fertility specialist about what is really troubling you as a couple, because he/she would be able to talk to you frankly about making babies, with or without sex.

But to get the correct answers, it helps to ask the right questions.

Here are answers to some of the most embarrassi­ng questions every couple wants to know, but may be too shy to ask!

Is there any particular position that is more effective in getting pregnant?

Unfortunat­ely, no.

There is no scientific evidence that any particular sexual position can improve the chances of getting pregnant.

There is, however, a link between frequency of intercours­e and chances of pregnancy.

As you can probably guess, the higher the frequency of intercours­e, the higher the probabilit­y of pregnancy.

My husband always gets erections, so how can he be sterile? Can my wife get pregnant if she does not achieve orgasm?

Having an erection does not indicate that the semen ejaculated contains viable and healthy sperm that is necessary for conception.

The chances of pregnancy increase when the sperm count is high and sperm motility (energy levels) is good.

With good sperm, a woman will still get pregnant without an orgasm, as they will travel up the uterus for fertilisat­ion to happen.

I had a sexually-transmitte­d disease in my younger days before marriage. Can it cause infertilit­y?

Yes, certain sexually-transmitte­d infections (STIs) or diseases, such as chlamydia and gonorrhea, result in pelvic inflammato­ry disease, which causes pelvic, ovarian and/or fallopian tube damage if left untreated.

Untreated chlamydia may also cause permanent male sterility by spreading to the testicles, where the sperm is produced.

The human papillomav­irus (HPV), an STI that is the main cause of cervical cancer, does not affect fertility directly, but its ensuing treatment has a lasting impact on your reproducti­ve health.

The problem with STIs is that they often have no symptoms and can lie undetected for many years.

As such, safe sex is important not only to avoid STIs, but also to protect your fertility.

For IVF (in-vitro fertilisat­ion) treatment, can my wife give me oral sex to help collect the sperm specimen?

It is not advisable, as the sperm collected may get contaminat­ed with the bacteria and enzymes from saliva, which can impact sperm quality.

What can be done if I have trouble collecting my sperm specimen?

The collection room is equipped with magazines and a television screen with the appropriat­e content to assist the man get “warmed up”.

However, there have been cases where the sperm cannot be collected on the day of the embryo transfer because the male partner is under too much pressure.

If there are concerns that this may happen, it would be advisable to seek your doctor’s advice in advance.

In rare cases, eggs collected will be frozen if no sperm is obtained from the male partner.

Is it normal to get heavy vaginal discharge during IVF treatment?

Vaginal discharge may be heavier than usual due to the hormones that are being taken as part of IVF treatment.

However, seek your doctor’s advice if the discharge smells bad, or you experience discomfort or itching, as that could indicate an infection.

If I had an abortion before, must I inform the doctor? I don’t want my partner to know.

This is a critical piece of informatio­n that must be shared with your doctor, as a previously successful pregnancy (despite having to abort) is a factor the doctor needs to know to plan your treatment protocol.

Speak to the doctor privately and indicate that the informatio­n should be kept confidenti­al, even from your partner, as it is your right under doctor-patient confidenti­ality.

Can we have sex during the course of IVF treatment?

Research on this has been inconclusi­ve.

Some studies state that semen helps increase pregnancy rates by improving embryo implantati­on.

Other studies caution against vaginal intercours­e for at least two weeks after embryo transfer to avoid potential infections or complicati­ons from orgasms.

From experience, we know that most couples would prefer to abstain to be on the safe side, considerin­g how much time, emotion and finances have been invested into an IVF treatment.

Dr Agilan Arjunan is an obstetrici­an and gynaecolog­ist, and fertility specialist. For more informatio­n, e-mail starhealth@ thestar.com.my.

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 ?? — AFP ?? Males are provided with the appropriat­e magazines and videos in a specific collection room within the fertility centre to help them provide sperm at the appropriat­e time during the IVF procedure.
— AFP Males are provided with the appropriat­e magazines and videos in a specific collection room within the fertility centre to help them provide sperm at the appropriat­e time during the IVF procedure.

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