• Dr Peter Chew

Q & A during Talk & Movie Event on March 10th 2018

1. Can endometriosis be detected early or must we only perform the scan together with surgery? Was told by a professional that it is a one time process.

Early detection of endometriosis is by clinical suspicion based on history and physical examination and confirmed by laparoscopy. Early stage without endometriotic cyst cannot be seen by ultrasound scan.

2. Typically, my menses is around 30-35 days but around 3 times a year, it will be longer than 40 days i.e 40 plus and 50 plus days. I have went through all medical checks, no issues. Doctor also ruled PCOS out. What could be the root cause other than stress?

There are many causes of irregular periods and Stress and PCOS are some of the causes. Thyroid glands dysfunction (hypo- or hyperthyroidism), increased milk hormone (prolactin) from the pituitary, chronic medical illnesses like diabetes or kidney problems are some of the causes of irregular menses.

3. How long would you recommend couples in early 30s to try naturally before taking ART?

There is no hard and fast rule on how long one should try naturally before resorting to ART. It depends on the cause of infertility. For example, if the tubes are blocked, one should resort to ART straightaway. Normally, if the female is in early 30s , she should try naturally for about 6 months without contraception. If conception does not occur, she should seek medical help to find out the cause so that appropriate treatment can be given.

4. How long after conceiving then you will have early pregnancy symptoms? Normally you get your period about 4 weeks from the start of your last period, but if you're pregnant, the sign at this point is a missed period. Many women still feel fine after getting overdue for a week, but others may notice sore breasts, fatigue, frequent urination, and nausea.

5. My wife is undergoing TB treatment, what is the risk of pregnancy?

If the TB responds to the treatment and after doctor has declared her well after treatment , she can try to get pregnant. However, if she is pregnant and treatment is in progress, then you should consult the chest physician with regards to the safety profiles of the medications with reference to the unborn foetus.

6. Can adenomyosis be treated?

Please refer to the website article on Q & A about adenomyosis.

7. What are the tests that you will suggest for the couple before trying for a baby?Please refer to the Q&A fertility tests in the website.

8. What are the possible causes for non fertilization during ICSI?

Few reasons:

  • Technical failure,

  • Poor egg quality,

  • Poor sperm quality,

  • The egg may not have survived after the injection,

  • The DNA of the sperm head may remain ‘locked’,

  • The egg may not have been activated and didn’t participate in the intracellular steps of fertilization.

9. If ovulation tests (ovulation test kit) was done daily during the female’s ovulation period (using menses calender app) but the result always negative. What could be the possible reason?

Few reasons:

  • The OPK is faulty,

  • Urine does not contain enough LH,

  • Technical fault,

  • Luteinized Unruptured follicular syndrome.

Please refer to the Q&A on ovulation kit.

10. If the menses is regular (average 36 days for every cycle) but flow is very little, does it affect the plantation of the embryo or fertility? Is there anyway to improve the menses flow?

Scanty flow may indicate a thin uterine lining and this may affect implantation of the embryo. It may indicate dysfunction of ovulation or poor corpus luteal formation You should find out the cause and treat it appropriately.

11. After miscarriage, does it affect chances of conception?

Usually, one previous miscarriage does not affect chances of having a subsequent pregnancy. But if there are 2 or more recurrent miscarriages, subsequent chances of conception may be affected

12. What can I do to regulate my cycle?

You should find out the cause of the irregular periods so that appropriate treatment can be given. Please refer to the article on Q&A irregular periods in our website.

13. My wife got pregnancy 8 weeks and 4 days over, but no vomiting. Is it problem or no worries, please guide me.

About 20 % of pregnant women has no vomiting. As long as the baby is viable with the presence of heart beats, do not worry.

14. Is it unadvisable to go to Japan if you’re planning to conceive? Also does mint or alcohol affect sperm count?

There is no reason to advise you against travelling to Japan if you are planning to conceive.Alcohol do affect sperm quality and quantity if you take it in excess.

15. Does anything affect egg count?

Egg count can be affected by many factors such as age, life styles, STDs,BMI, endocrine diseases and medications.

16. What are the chances of natural pregnancy if one is diagnosed with teratozoospermia? Morphology is only 1%. Must we go thru ART or can still try natural?

It depends on the quantity of the sperm. E.g. 1% of 100 million/ml is better than 10% of 1million/ml.Besides, this percentage can change day by day and varies from laboratory to laboratory. You can still try naturally.

17. What is the main cause of ED problem, how to overcome the ED? What is testosterone symptom that affect man?

Please refer to the article in our website Q&A Erectile dysfunction.

18. My wife in early 40s, her period is reduce from 7 days to now 2 days since recently? What is the cause?

Please refer to the article in our website Q&A scanty periods.

19. What happens if the morphology is only 2%? Is there any treatment?

Morphology is about the shape of the sperm.If the sperm is misshaped, it can’t penetrate the egg effectively and so conception becomes compromised.

To improve:

  • Regular exercise,

  • Balanced diet with plenty of vitamins, antioxidants and micronutrients like zinc and selenium,

  • Avoid processed food,

  • Reduce exposure to chemicals and pesticides,

  • Stop smoking and reduce alcohol intake,

  • Avoid heat like spa, hot baths, saunas,

  • Check for varicoceles. Varicoceles are varicose veins around the testicles.

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