According to Dr Wong Pak Seng, the best time to visit a fertility specialist is within the first two weeks of your period. This is the time when tests and examinations would offer the most accurate insight into your ability to have children.

Is it fine to call the fertility specialist centre directly, or do you need to be referred by your doctor?

Dr Wong claims that either approach is fine. “In other countries, such as the UK, you need to be referred in order to receive treatment at fertility centres. In our country, there is currently no nationwide referral system, so at this moment Malaysian fertility centres welcome all couples, with or without referrals.” 

Money matters

While the actual cost can vary depending on the fertility centre you happen to visit, Dr Wong estimates that you may need to spend RM14,000 to RM20,000 for a single in-vitro fertilisation (IVF) treatment. This amount does not take into account additional costs for preliminary examination, medication and such.

There are fertility centres that are starting to offer low-cost IVF for couples with tighter budget. This usually involves the use of smaller doses of hormones, and as a result, smaller number of eggs would be obtained and the success rate is correspondingly lower.

However, “smaller chance” does not necessarily mean “very low chance”. The low-cost IVF is still a viable option, as many childless couples in countries such as Australia (where low-cost IVF is widely available) have found success in creating their special bundle of joy this way. This is something worth considering if you cannot afford the higher-end packages. 

Fitting treatment into your normal routine

You may be wondering at the back of your mind, “Do I need to take a long leave to undergo fertility treatment?”

According to Dr Wong, fertility treatment nowadays causes only minimal disruption of your normal routine. “These days, treatments especially in-vitro fertilisation (IVF) have been simplified. In the past, you’d need to take one whole month to receive hormone injections. Now, you only need 10 days of hormone injections and have your eggs harvested on the 12th day or so. The entire process takes up to16 days,” he says.

He goes on to add, “The injections can be applied by the woman on her own, so she can still continue her normal routine such as going to work. She only needs to visit the fertility centre so that we can collect her eggs. All in all, she only needs to take a few days of leave from work at most.”

Now, let’s have Dr Wong explain what you can expect when you visit a fertility centre.

Let’s get to know you

Because the circumstances behind one’s inability to have children usually differ from one couple to another, fertility specialists often devise customised treatment programmes for each couple. 

“Therefore, the first visit involves getting as much information as possible from the couple,” explains Dr Wong. You would be asked questions related to your health and lifestyle. The answers are then used to identify the possible causes of your inability to have children.

The questions typically cover the following:

• Gynaecological history, such as your periods, birth control methods used, frequency of Pap smears and their results, history of sexually transmitted infections (which can affect the ability to have children).
• Obstetric history, such as whether you have any history of miscarriage, ectopic pregnancy, and abortion. If you already have children, you may be asked about the method of delivery, any complications that occurred during delivery, medications taken before and after childbirth, the baby’s state of health post-delivery and more.
• Your lifestyle and habits, including whether you have ever had a sexually transmitted infection.
• Any current health conditions you have (such as diabetes or heart problems) and the medications you are currently taking.
• Once the fertility specialist team has gathered enough information, the next step would be to conduct some tests to determine both the possible causes of infertility and the best ways to overcome these causes.
• A vaginal and pelvic ultrasound would be conducted to determine the state of the reproductive organs (ovaries, fallopian tubes, cervix, vagina in the woman; testicular tubes in the man) while a sperm sample would also be extracted for studies. Dr Wong also says other tests may include the anti-Müllerian hormone test (which requires a blood sample) and egg reserve test. All these tests can be conducted within the same day.
• Once your background and the test results have been analysed, the fertility specialist would then advise on the next steps.

Emotional support

A couple undergoing fertility treatments may experience stress and frustration stemming from the uncertainties they face, and a failed treatment may result in feelings of despair and guilt. Dr Wong points out that, in light of this, many fertility centres offer counselling services as part of the treatment package. Therefore, once you sign up for fertility treatments, do not hesitate to confide in your counsellor and seek emotional support when necessary.

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