Expert: Infertility on the rise

Many couple now wait up to two years before having a child

KUALA Although Malaysia does not have official statistics on its infertility rates, there has been an obvious increase in the number of couples who are unable to have children despite being married for several years.

Gynaecologist Dr Azirawaty Mohd Tadzri, who is a partner at a private clinic in Ampang, Selangor, said while in the past women had the tendency to become pregnant within three months of marriage, nowadays it took them more than a year or two to conceive although they were physically normal and had healthy wombs and eggs.

“Almost 70% of my patients (who have trouble starting a family) who come to me for consultation and treatment are under 30 years old and many of them had been married for two or three years,” she said.

She also said the perception that the inability to conceive was mainly due to female infertility was no longer applicable as studies have shown that male infertility was also on the rise due to declining sperm quality.

“When examining sperm samples, we can determine the quality by looking at how fast they move, as well as the sperm count.

“During detailed examination under a microscope, we regularly come across unhealthy sperm and even deformed ones that feature two or three heads,” she said, adding that unhealthy lifestyle habits are among the reasons for the decline in sperm quality.

According to the Vital Statistics Malaysia 2017 report, the national fertility rate in 2016 had been the lowest ever recorded since the formation of Malaysia in 1963, with the fertility rate per woman aged 15 to 49 in 2016 being 1.9 babies, a decrease from 2.0 babies in 2015.

The total fertility rate in Malaysia has been below the replacement level of 2.1 babies (which is the average number of babies born per woman throughout her reproductive life) and is insufficient to replace herself and her partner.

The simplest treatment for infertility are hormone injections which can stimulate the ovaries to overproduce eggs to increase a woman's chances of pregnancy.

If this does not work, the couple could opt for either intrauterine insemination (IUI) or in vitro fertilisation (IVF), said Dr Azirawaty.

She said couples living in urban areas often lead stressful lives as many of them have to hold two or three jobs in order to cope with the high cost of living, adding that fatigue could lead to women having what was termed as “sleepy” (or poor functioning) ovaries. Stressed conditions also produce hormonal imbalances in a woman, which can lead to irregular menstrual cycles.

Dr Azirawaty has come across many cases of women whose periods become irregular after they get married.

“This could be due to the stress factor and it becomes more difficult for these women to conceive,” explained Azirawaty.

Stress could also build up if family and relatives keep asking a couple when they intend to produce an offspring, she added.

“It gets worse when their friends share pictures of their babies on social media. Seeing such photos makes them more despondent over the inability to conceive,” she said.

Dr Azirawaty also advised couples to change their lifestyles if their infertility is due to unhealthy habits and chronic diseases like hypertension and diabetes.

Obesity could also affect the egg and sperm quality, she said, adding that couples should strive to have a normal body mass index.

During detailed examination under a microscope, we regularly come across unhealthy sperm and even deformed ones ... Dr Azirawaty Mohd Tadzri