In our current modern day Singapore, more and more couples are choosing to get married at a later age. This has been the talk of the town from our government in recent years.

Many even postpone starting a family till an even later age due to various factors such as careers or other lifestyle factors.

Fertility rates for BOTH women and men decrease with age, which makes it unsurprising that more couples are finding trouble conceiving nowadays.

graph showing declining fertility for women with age

Have you been trying for a child without any luck the past year?

You may wish to consider undergoing fertility screening for you and your partner.

Fertility screening will allow a couple to have a better idea and understanding of their reproductive health. This will allow for timely intervention if any abnormalities are detected.

Should Everyone Undergo Fertility Screening?

couple seeking fertility treatment

Fertility screening is currently recommended for:

  • Couples who have been actively trying to conceive for at least a year OR
  • Couples > 35 years old who have been actively trying to conceive for 6 months

However, it is always better to get screened earlier than too late!

Couples who wish to conceive are recommended to get screened early, even before you actually start trying.

This is EVEN more crucial if either partner has had any medical history or surgery related to their reproductive organs.

What Exactly Does “Fertility Testing” Test For?

The answer to this question differs between men and women.

For Men

sperms and semen analysis

Fertility testing for men is pretty straightforward – Men just have to produce a sample of their semen for semen analysis!

Further tests may be ordered by your doctor if the results of the semen analysis reveals any abnormalities or problems.

For Women

On the other hand, fertility screening for women is a more tedious process, which involves several different tests.

Fertility screening for women can be broadly classified into 5 types of tests:

  1. Hormonal Blood Tests
  2. Preconception Blood Tests
  3. STD Screen
  4. PAP smear
  5. Scans
  1. Hormonal Blood Tests

    basket of eggs representing female egg reserves

    These tests include female hormonal levels looking out for any

    • Hormonal imbalances
    • Ovulation problems
    • Ovarian reserve
    • Premature menopause
  2. Preconception Blood Tests

    blood tubes for fertility blood tests

    Preconception tests include screening for maternal infections and blood disorders that can affect a pregnancy and the baby

      • HIV/Hepatitis B/Syphilis Screen
      • Full Blood Count
      • Rubella Antibody
      • Thalassemia Screen
      • Blood Group and Rhesus Status
  3. STD Screen

    picture showing pelvic adhesions and pelvic inflammatory disease caused by chlamydia

    The most common STD that can affect a woman’s fertility is chlamydia.

    Very often, long standing chlamydia infection can be asymptomatic, and women do not know they have this infection until they have difficulty conceiving.

    Long-standing and untreated chlamydia infection can lead to pelvic inflammatory disease, which causes adhesions and scar tissue in the pelvic organs making it difficult to conceive.

  4. PAP Smear

    brushes used for PAP smear

    A PAP smear is a simple screening tool done to screen for cervical cancer, or pre-cancer cell changes.

    Your doctor can easily perform it in the clinic by using a vaginal speculum to visualize the cervix, then using a special brush to obtain cell samples from the cervix.

    It is important to ensure your cervix is healthy prior to conceiving.

  5. Scans

    There can be various types of scans done to evaluate a woman’s fertility, and each type of scan tells us something different that may contribute to a woman’s infertility.

    1. Ultrasound Pelvis: A trans-vaginal scan is usually performed to evaluate your uterus, tubes and ovaries. This looks for growths in the ovary and womb or even swollen fallopian tubes.trans-vaginal ultrasound pelvis
    2. Saline Sonogram: Mainly to evaluate the womb and womb liningimage of saline sonogram showing 2 polyps in the endometrial cavity
    3. Hystero-salpingogram: To test for patency of the fallopian tubespicture showing how a hysteron-salpingogram is done
    4. Hysterosalpingo-foam Sonography ( HyFoSy): To evaluate for growths and patency of fallopian tubespicture showing how a Hysterosalpingo-foam Sonography is done

    Each type of scan is specialized and will require special facilities to perform them.

    The availability of each type of scan will depend on which clinic/imaging centre/hospital you are at, but rest assured that your doctor will discuss and arrange for the appropriate scans for you!

Conclusion

If you are reading this and trying to conceive, do make an appointment to see your doctor earlier rather than later for fertility screening!

Always have a detailed and honest discussion with your doctor regarding your needs, wants and expectations so that the most appropriate and best treatment can be provided to you.