THE fairy tales always talk about the happily ever after — young maiden meets her prince charming, they fall in love, get married and live happily ever after (you know the drill).
The same stories, however, never talk about what comes after — working at the marriage, keeping house together as adults and for a number of married couples, trying for a baby.
Most couples have no problems conceiving once they decide to try for a baby but for an increasing number of couples, the pitter-patter of tiny feet is an elusive goal…and they suffer in silence.
While it is a private and personal difficulty, infertility has wider implications for the country.
A lower fertility rates equates to a dropping population growth, which leads to an aging population, which brings on a host of other issues.
A recent Bernama report quotes University Malaya Faculty of Economics and Administration lecturer Professor Dr Noor Azina Ismail as saying that socio-development has caused fertility to decline rapidly since the 1980s.
“The decline in fertility rates has caused population growth to drop each year, while the number of people aged 60 and above continue to rise.”
The article also points out how in the West, greying populations have sparked concerns about increased public expenditure on unemployed seniors in terms of pension and health costs.
At its current growth rate, Malaysia is slated to become an aging nation — where 15% of its population is made up of senior citizens — by the year 2030.
Obstetrician & gynaecologist and fertility specialist Dr Wong Pak Seng told The Rakyat Post that in the Asia-Pacific region, total fertility rates have fallen to the population replacement rate of 2.1.
“In Asia, with persisting social and personal barriers, low fertility awareness and limited access to treatment access, the figures are even lower. Globally, Asian fertility rates are at its lowest since the 1960s, and are lower than collective rates globally.
“In general, 1 in 10 couples grapple with some form of fertility issues. While there is no data available for Malaysia, it is estimated that about 800,000 couples have subfertility. In developed countries, the prevalence seems to be higher, about 1 in 6 couples. This is possibly due to greater awareness and better funding for fertility treatments leading to more couples coming forward,” he says.
With all this in mind, the Malaysian Society for Assisted Reproductive Technology (MSART) and Merck Serono have embarked on a campaign to raise awareness about infertility, and to offer guidance and information on treatment options for those wanting to start a family.
The organisers of the Hope for a Child campaign hope to encourage couples who are facing infertility and considering in vitro fertilisation (IVF) to see a doctor and receive proper medical advice and guidance on their journey through treatment with the hopes of conceiving.
It also hopes to assist fertility experts to disseminate proper guidance and support to patients who are undergoing treatment.
The campaign aims to dispel the many myths and misconceptions about infertility, including the belief that it is almost always a woman’s problem, that a man’s fertility does not change with age and that all couples can conceive almost immediately when they start trying.
Infertility can be caused equally by the man or the women — one-third are caused by women’s problems, one-third by men’s and the remaining one-third a mixture of male and female problems or by unknown problems.
Many of the risk factors for both male and female infertility are the same, including age. While a woman’s fertility potential gradually declines after about age 35, a man’s does the same after 55.
The chance of conception in each month of trying is about 15%. Even if there is nothing wrong, it may take a couple six to eight months to conceive. It takes even longer if the woman is older.
Aside from age, other major contributing factors to infertility include tobacco smoking, excessive alcohol consumption, being over- or underweight and too much exercise.
In any case, Dr Wong stresses that it is important for couples to communicate and support each other.
“If tobacco smoking, excessive alcohol and weight issues are a contributing factor, couples will need to review their lifestyle such as fitness and diet. It is good to plan the best time for conception as well,” he adds.
He also advises couples facing fertility problems to speak to their doctors and seek proper medical attention.
“Time is of the essence, so do seek help earlier rather than later. It can be an anxious time for couples trying to conceive, so do maintain good relationship communication and keep optimistic!”
There are many options available to infertile couples — assisted reproductive technologies (including IVF and intracyto-plasmic sperm injection), hormonal therapies, surgical procedures and other treatments, such as egg and embryo freezing and egg donation.
In general, he stresses the importance of starting a family and having the first child by the age of 35 as far as possible.
If this is not possible and if the couple can afford to, freezing fertilised eggs for use at a later stage is an option
But if cost is an issue, the couple should seek the advice of a fertility doctor to assess their reproductive potential.
“If there are no issues, child bearing can be delayed until the age of 35 (female partner’s age). On the other hand, if there is a potential issue, it is advisable to start a family earlier rather than later.”
This is where the Hope for a Child campaign comes in — the website serves as a one-stop resource for couples seeking to learn more about in infertility, treatment options, support throughout the treatment process and also includes a fertility centre locator.
The campaign will also see the development and dissemination of educational materials such as patient information leaflets on infertility, which will be made available to those seeking treatment at the fertility centres.
For more information on infertility and the Hope for a Child campaign, visit www.fertilityasia.com.my