Some couples struggle to conceive despite being married for a long time and having regular unprotected intercourse. Fertility programs available at fertility centers can help couples achieve their desired pregnancy while ensuring a healthy and safe pregnancy journey.
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When to Consider a Pregnancy Program
Ideally, pregnancy program preparation should begin 3-6 months before planning for pregnancy. During this period, doctors provide medical advice to enhance fertility in both partners and minimize potential pregnancy complications.
You may need to consult an obstetrician-gynecologist (OB-GYN) and consider a pregnancy program if you:
- Want to conceive immediately after marriage
- Are a woman over 30 years old
- Have been trying to conceive for over a year without success
- Are obese
- Have a history of sexually transmitted infections (STIs)
- Have hormonal disorders
- Have thyroid disease
- Have endometriosis
- Have pelvic inflammatory disease
- Have polycystic ovary syndrome (PCOS)
- Have inflammation in the fallopian tubes
- Have a genetic disorder affecting reproductive function
- Have an autoimmune disease targeting reproductive organs
- Have ejaculation problems
- Have uterine abnormalities
- Have had a miscarriage
- Have undergone medical procedures on reproductive organs
- Have undergone or are undergoing cancer treatment
- Are frequently exposed to cigarette smoke, alcohol, or toxic chemicals
Consultation Procedures for a Pregnancy Program
Before starting a pregnancy program, couples must consult a fertility specialist to assess their health and fertility condition and determine the most suitable program.
1. Medical Interview
During the initial examination, the doctor will conduct anamnesis (medical history-taking) and ask about:
- Menstrual cycles
- Types of contraceptives previously or currently used
- Medical history of chronic diseases and infections
- Family history of hereditary diseases
- Sexual development during puberty
- Sexual behavior history
- Medications, including herbal remedies and supplements
- Past medical procedures
- Vaccinations received
- Lifestyle habits, including exposure to toxins like cigarettes and alcohol
2. Physical Examination
A physical examination before the pregnancy program includes general tests such as height and weight measurement, body fat and muscle distribution assessment, skin and hair condition evaluation, and a visual examination of the genitalia and breasts.
Doctors also look for signs of hormonal imbalances affecting fertility, such as excessive facial hair growth in women (indicating hormonal imbalances) or decreased testicle size in men (suggesting low testosterone levels). Varicocele (enlarged veins in the testicles) may also affect male fertility.
3. Additional Examinations
To assess a couple’s fertility or identify infertility causes, further tests may be recommended, such as:
- Blood tests to check hormone levels
- Genetic tests to detect potential chromosomal or genetic disorders
For male fertility screening, the primary test is semen analysis, which examines sperm quality based on count, movement, and shape. Other tests may assess the condition of the testes, epididymis, and scrotum.
For female fertility screening, a pelvic examination is performed to evaluate the uterus and fallopian tubes using methods such as:
- Pelvic ultrasound
- Hysterosalpingogram (HSG)
- Sonohysterogram
- Hysteroscopy
- Laparoscopy
Types of Pregnancy Programs
After evaluation, doctors may recommend one of the following pregnancy programs based on the patient’s condition:
1. Ovulation Induction
Ovulation induction is a medical procedure to regulate ovulation and increase the number of mature eggs each month, thereby improving the chances of conception. This method is generally recommended for women with irregular menstrual cycles.
Ovulation induction can be done using injectable or oral medications, such as clomiphene citrate, which stimulates the production of follicle-stimulating hormone (FSH) to promote egg maturation.
The process starts with fertility medication during the first week of the menstrual cycle. The woman’s condition is monitored via ultrasound, allowing doctors to predict ovulation. Engaging in intercourse during ovulation increases the chances of pregnancy.
2. Artificial Insemination
Artificial insemination is a pregnancy program in which sperm is directly inserted into the uterus using a catheter.
In this procedure, the husband’s sperm is collected and processed in a lab to separate healthy sperm from semen and poor-quality sperm. The best sperm are then inserted into the wife’s uterus during ovulation.
This method increases the number of sperm reaching the fallopian tubes, improving the chances of fertilization. The success rate of artificial insemination is around 10-15%.
3. In Vitro Fertilization (IVF) or Test-Tube Baby
IVF involves retrieving mature eggs from the wife during ovulation and fertilizing them with the husband’s sperm in a special dish in the lab. Fertilization occurs outside the mother’s body.
Several eggs and sperm are combined, and if fertilization is successful and an embryo forms, it is transferred into the uterus to continue pregnancy naturally. The success rate of IVF is around 40-50% per cycle.
4. Intracytoplasmic Sperm Injection (ICSI)
Similar to IVF, ICSI involves fertilization outside the body. However, in ICSI, a single high-quality sperm is selected and injected directly into the egg using a microinjection needle.
ICSI is recommended when only a few healthy sperm are available. The best sperm is selected to increase the chances of successful fertilization. This technique is an advanced version of IVF, requiring higher technology and expertise.
5. Surgery
Difficulties in conceiving may also be due to structural issues in reproductive organs. In such cases, surgical intervention might be necessary to enhance fertility.
Several types of fertility-enhancing surgeries include:
- Surgery to clear blocked fallopian tubes
- Laparoscopy to diagnose and treat endometriosis, cysts, and blockages
- Hysteroscopy to remove fibroids, polyps, or adhesions that impact fertility
Consultation & Pregnancy Program Services
If you and your partner are hoping to conceive, consider an infertility assessment and pregnancy program with the Fertility & Andrology Consultant Team at Royal Mandaya Hospital.
The Fertility Clinic at Royal Mandaya Hospital offers male and female fertility tests. Couples can also enroll in the 25-day pregnancy program, guided by experienced fertility specialists.
For easier access, use the Chat via WhatsApp, Book Appointment, or Care Doctor app, available on Google Play and the App Store, to schedule visits, check queue numbers, and get complete information.
