How Robotics Can Help a Stroke Survivor’s Brain to Relearn How to Walk at a Faster Rate

WORDS LIM TECK CHOON

FEATURED EXPERT
DR KOK CHIN YONG
Consultant Neurologist and Internal Medicine Physician
Sunway Medical Centre Velocity
FIRST, LET’S TAKE A LOOK AT STROKE

Stroke is a medical emergency caused by the disruption of blood flow to your brain.

Without enough oxygen, your brain will stop working properly. This is why stroke is often considered the brain’s version of a heart attack.

 

Ischaemic stroke

This occurs when there is blood flow disruption to the brain. This can occur when the blood vessels in your brain are blocked by blood clots or other substances.

This is the most common type of stroke and is often linked to poorly controlled type 2 diabetes, high blood pressure, and/or high blood cholesterol levels.

Haemorrhagic stroke

This type of stroke occurs when there is internal bleeding in the brain. Accumulated blood in certain areas of the brain can exert pressure to brain tissues in these areas and damage these tissues.

While not as common as ischaemic stroke, this type of stroke is especially dangerous because the affected person’s symptoms can get worse very quickly and urgent medical attention is needed to prevent permanent brain damage and even death.

MOST STROKE SURVIVORS EXPERIENCE GAIT DISABILITY

Stroke is one of the main causes of disability.

2005 statistics from the American Heart Association revealed that more than 80% of stroke survivors suffer from gait disability—the loss of mobility due to impaired ability to walk normally.

Gait disability can affect the survivor’s quality of life.

However, there are also other repercussions of this disability on the person: the person’s confidence and sense of independence can be compromised.

Furthermore, gait disability is linked to increased risks of cardiovascular diseases and death in people approaching 80.

Because of this, gait therapy is an important aspect of rehabilitation for a stroke survivor.

ALL IS NOT LOST, AS THE BRAIN HAS A CHANCE TO ADAPT & RECOVER

The brain is an amazing organ. The network of nerves and other tissues involved in brain function can adapt to changes by reorganizing themselves, or ‘rewire’ in response to these changes.

“This can happen after a stroke,” Dr Kok explains, “as the brain begins to compensate for the damage caused by the stroke.”

This process, called brain neuroplasticity, can involve the formation of new connections between remaining healthy nerves and ‘recruiting’ other parts of the brain to take over the functions that were handled by the now-damaged part of the brain.

Much research is being done on the neuroplasticity of the brain to explore possible ways to improve the rehabilitation process of people that had a stroke or other brain injuries that affect their normal day-to-day function.

Currently, research data increasingly suggests that techniques that can stimulate the part of the brain affected by stroke can help improve the rehabilitation of the lost function linked to that part of the brain.

HENCE, GAIT THERAPY IS AN ESSENTIAL COMPONENT OF A STROKE SURVIVOR’S REHABILITATION

Dr Kok Chin Yong mentions that the restoration of a stroke survivor’s ability to walk can be a complex process.

The stroke survivor’s inability to walk normally is usually due to the stroke disrupting the function of the nerve pathways in the region of the brain that plans and controls movement called the motor cortex.

Furthermore, the stroke survivor also often suffers from other debilitations that make it harder for them to walk, such as changes in their muscle tone and strength as well as impaired heart function.

Additionally, the more gait therapy is delayed, the harder it is to achieve a good outcome because the organs involved in walking will further weaken and waste away due to lack of use.

Hence, gait therapy should be prioritized as soon as it is feasible to do so.

ROBOTICS-ASSISTED GAIT THERAPY CAN BENEFIT STROKE SURVIVORS CONSIDERABLY
If you have not read Dr Foong Chee Chong’s explanation of what robotic-assisted gait therapy is, you can do so by clicking here. Have a read, and then hit the back button to come back here and continue reading—it will help you better understand the rest of this article!

Dr Kok explains that the first line of rehabilitation is conventional physiotherapy.

“During this stage, we will assess the patient’s suitability for robotics-assisted gait therapy,” he explains, adding that the criteria for suitability are similar to those explained by his colleague Dr Foong is the above-linked article.

“The main benefit of the use of robotics is that many patients can regain their normal physiological walking at a faster rate than conventional physiotherapy,” he shares.

He elaborates that this is due to the robotic exoskeleton stimulating the neuroplasticity of the patient’s brain, helping it to relearn how to order and control the movement of the patient’s lower limbs at a much faster rate.

He reiterates that such outcome is more likely achieved when the robotics-assisted gait therapy is initiated as early as it is feasible to do so.

Hence, he encourages stroke survivors to consult their doctors further on whether such a therapy is suitable for them.

THIS IS THE SECOND PART OF THE SERIES LEARNING TO WALK AGAIN

Below are the articles in this series:

  1. A Rehab Specialist Explains How a Robot Can Help You to Learn Safely & Successfully to Walk Again
  2. How Robotics Can Help a Stroke Survivor’s Brain to Relearn How to Walk at a Faster Rate (you’re reading this article now)

References:

  1. Duncan, P. W., Zorowitz, R., Bates, B., Choi, J. Y., Glasberg, J. J., Graham, G. D., Katz, R. C., Lamberty, K., & Reker, D. (2005). Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke, 36(9), e100–e143. https://doi.org/10.1161/01.STR.0000180861.54180.FF
  2. Newman, A. B., Simonsick, E. M., Naydeck, B. L., Boudreau, R. M., Kritchevsky, S. B., Nevitt, M. C., Pahor, M., Satterfield, S., Brach, J. S., Studenski, S. A., & Harris, T. B. (2006). Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA, 295(17), 2018–2026. https://doi.org/10.1001/jama.295.17.2018
  3. Su, F., & Xu, W. (2020). Enhancing brain plasticity to promote stroke recovery. Frontiers in neurology, 11, 554089. https://doi.org/10.3389/fneur.2020.554089
  4. Selves, C., Stoquart, G., & Lejeune, T. (2020). Gait rehabilitation after stroke: review of the evidence of predictors, clinical outcomes and timing for interventions. Acta neurologica Belgica, 120(4), 783–790. https://doi.org/10.1007/s13760-020-01320-7

A Rehab Specialist Explains How a Robot Can Help You to Learn Safely & Successfully to Walk Again

WORDS LIM TECK CHOON

FEATURED EXPERT
DR FOONG CHEE CHOONG
Consultant Rehabilitation Medicine Specialist
Sunway Medical Centre Velocity
FIRST, LET’S TAKE A LOOK AT GAIT THERAPY

Gait therapy is a form of physical therapy to help improve one’s ability to walk.

COMMON HEALTH ISSUES THAT LEAVE ONE WITH DIFFICULTIES IN WALKING
Stroke
Osteoarthritis
Cerebral palsy
Parkinson’s disease
Joint replacement surgery
Lower limb paralysis
Multiple sclerosis
Traumatic brain injury
Muscle weakness due to long periods of inactivity or immobilization

Gait therapy is typically conducted by a rehabilitation medicine specialist together with a physiotherapist and assisting personnel such as nurses.

If the affected person needs counselling or experiences mental issues such as depression due to their inability to walk normally, a counselor or psychiatrist will also be involved.

INTRODUCING ROBOTIC-ASSISTED GAIT THERAPY

Consultant rehabilitation medicine specialist Dr Foong Chee Chong reveals that this technology has been around for the last decade or so, and it is increasingly adopted in Malaysia as part of gait therapy.

It’s a bit like Tony Stark and the Iron Man suit!

Dr Foong shares that in robotic-assisted gait therapy, the robotic device used is a wearable robotic exoskeleton.

There are a few different types of robotic exoskeletons available, and the specific way each works may vary from other types.

However, they generally work in the following manner:

  1.  There is a control panel, placed usually at the back of the exoskeleton, that allows the physiotherapist to adjust the settings to the level of assistance needed by the patient. Such adjustment is based on the patient’s current abilities and needs.
  2. The robotic exoskeleton is a lightweight frame that will be strapped onto the patient’s torso and legs.
  3. Once activated, the robotic exoskeleton will provide powered assistance to the patient’s hips and knees, assisting the patient in performing walking and standing motions.
  4. The entire session will be supervised closely by the physiotherapist and their assistant, who will always remain close to the patient.
  5. Should the patient do something wrong, the robotic exoskeleton will emit a sound that will alert the supervising physiotherapist, so that they can tend to the patient and provide necessary advice and assistance.
What’s the benefit of using a robotic exoskeleton?

Improved rehabilitation. Studies have found that robotic-assisted gait therapy can lead to clinically significant improvements in lower-limb movements among stroke survivors and people with spinal cord injuries, when compared to conventional gait therapy.

Shorter rehabilitation period. Dr Foong points out that, unlike the human eye, the robotic exoskeleton is more precise in detecting issues faced by the patient as they try to walk during gait therapy.

Furthermore, data from each session is tracked to allow the physiotherapist and rehabilitation medicine specialist to review the patient’s progress and identity areas for improvement.

As a result, the patient’s gait recovery from their robotic-assisted gait therapy is usually faster than those that do not use this technology.

Less resources are needed. Conventional gait therapy requires more personnel to assist the patient. For example, Dr Foong mentions that an assistant may be needed to support each of the patient’s arms, while another will guide the movement of the patient’s legs.

With the use of the robotic exoskeleton, fewer personnel are needed.

CAN I SIGN UP FOR ROBOTIC-ASSISTED GAIT THERAPY?

Dr Foong points out that a person will need to meet certain criteria to be considered for such therapy.

The person can sit upright and stand without experiencing dizziness and other issues. “They need to be able to do these actions at least 30 to 45 minutes without experiencing dizziness and other issues,” Dr Fong explains.

The person’s joints and bones are supple and strong enough to move without experiencing fractures. Dr Foong says that, typically, medical examination and muscle strength assessment will be conducted first to determine whether a patient is suitable to put on the robotic exoskeleton.

The person’s mind is sharp enough. They need to have a sound mind and be able to follow instructions from the physiotherapist.

The person is within the stipulated height and weight limit. A robotic exoskeleton can only support a person up to a certain weight and is within the recommended height range.

For the Ekso machine, for example, it can fit patients under 100 kg and between 1.5 m and 1.9 m.

HOW LONG IS EACH SESSION?

“Each session is usually between 30 and 45 minutes,” Dr Foong says.

The number of sessions is determined on a case-by-case basis.

WILL I BE ABLE TO WALK LIKE I USED TO?

“It will depend on a few factors,” Dr Foong says.  “The most important factor is the severity of the stroke. However, majority of stroke survivors will regain some form of movement or ambulation after undergoing robotic rehabilitation.”

He adds that one’s walking ability typically declines over time due to age-related issues such as loss of muscle strength. Hence, it’s possible that one may need to undergo periodic gait training to improve their walking ability.

Additionally, Dr Foong recommends staying active to ensure that the improvements developed after gait therapy will persist for as long as example. For example, one can go for walks around the neighbourhood in the evenings.

THIS IS THE FIRST PART OF THE SERIES LEARNING TO WALK AGAIN

Below are the articles in this series:

  1. A Rehab Specialist Explains How a Robot Can Help You to Learn Safely & Successfully to Walk Again (this is the article you are reading now)
  2. How Robotics Can Help a Stroke Survivor’s Brain to Relearn How to Walk at a Faster Rate

Fertility Experts on How You Can Freeze Frame Your Hopes of Being a Parent for the Future

WORDS LIM TECK CHOON

FEATURED EXPERTS

DR ASHLEY CHUNG SOO BEE
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity
DR FARAH LEONG RAHMAN
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity

Not everyone that wants to be a parent can set out to become one at the present.

They may want to establish their career or education first, for example, or perhaps they aren’t certain that they are emotionally and financially ready to be a parent at the moment.

However, one’s fertility decreases over time, especially for women, so in the past, it would be a race against time to achieve one’s dreams of parenthood.

These days, technology has opened up the option of ‘freeze framing’ one’s fertility at their peak, for use when they are ready but their declining fertility at that point may make it more difficult for them to have a child.

This technology is called cryopreservation.

CRYOPRESERVATION OF A WOMAN’S EGGS
  • More popularly known as egg freezing, this procedure involves the extraction of a woman’s eggs for freezing and storage.
  • Dr Farah Leong Rahman shares that these eggs are frozen in liquid nitrogen at a temperature of around -195ºC.
  • The eggs can be stored indefinitely through an extremely quick freezing or vitrification process. However, the Human Fertilization and Embryology Association recommends that eggs should only be frozen for up to 55 years.
  • This is something that can be considered by women that wish to defer motherhood to a later age, or those that would undergo medical procedures that will affect their fertility such as cancer treatments.

“In egg freezing, a woman goes through a series of hormonal medications to stimulate her ovaries to produce more eggs,” Dr Farah tells us.

“Once the eggs are deemed to have reached maturation, egg retrieval is done to retrieve these eggs. From here, we can store these eggs for future use,” she adds.

OVARIAN INSUFFICIENCY & EGG PRESERVATION

“Ovarian insufficiency means the ovaries stop functioning earlier than expected (before 40 years old), leading to the absence of menstruation,” explains Dr Ashley Chung Soo Bee.

“If there is a family history of premature ovarian insufficiency, it is recommended for female family members to consider egg preservation prior to developing this condition if they plan to have a family in the future. Preserved eggs can be used through in-vitro fertilization to create healthy embryos for future pregnancies,” she adds.
CRYOPRESERVATION OF A MAN’S SPERM
  • A man’s sperm can also be frozen in a manner similar to egg freezing described above. This procedure is known as sperm cryopreservation.
  • A semen sample will be obtained through ejaculation and then sent to the laboratory for cryopreservation.
  • If the man is unable to produce semen naturally, Dr Ashley reveals that there are sperm retrieval procedures that may be able to overcome this issue.
  • This is an option that can be considered by men that would be undergoing treatments that can affect their fertility, such as cancer treatments. According to Dr Ashley: “Cancer treatment can cause lower sperm production, damaged sperm, or the inability to produce sperm. These effects on sperm production can be temporary or permanent, depending on the type of treatment one undergoes.”
IS CRYOPRESERVATION SAFE?

Cryopreservation is considered to be a relatively safe procedure.

“The survival rate of frozen eggs and sperm is quite high,” Dr Farah tells us, “although there is always a possibility that some cells may not survive the thawing process.”

When it comes to freezing one’s eggs, the ovarian stimulation process may cause natural elevation of hormone levels in the woman. Dr Ashley shares that this may lead to side effects such as:

  • Nausea.
  • Mood swings.
  • Hot flashes.
  • Headaches.

“A small number may be at risk of ovarian hyperstimulation syndrome or OHSS, and may experience symptoms such as nausea, flatulence, tummy discomfort or pain, and vomiting,” Dr Ashley adds.

To minimize the risk of side effects, the fertility doctor will come up with a customized regime based on one’s needs, age, health status, and other factors.

 

Doctors Answer Parents’ Burning Questions About Eczema and Children

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MELANIE MAJAHAM
Consultant Paediatrician
Sunway Medical Centre Velocity

WHY DOES MY CHILD HAVE ECZEMA?
Dr Melanie Majaham explains that:

  • Eczema usually happens in a child that already has a tendency for dry skin.
  • The child’s skin becomes inflamed and very itchy when they are exposed to triggers such as chemicals, sweat and heat.
  • Red, dry, itchy patches form on the skin as a result of the inflammation.
  • Because of the itch, the child will constantly scratch their skin, which can lead to further damage to the skin. Blisters, oozing, crusting, and sores are some possible consequences from the constant scratching.
  • Such damaged skin leaves the child vulnerable to bacterial, viral and fungal infections.
HOW IS ECZEMA TREATED?

Dr Melanie says that treatment options will depend on which phase the eczema is in.

Active flare-ups
  • In active flare-ups, the child may need steroid-based creams to reduce the inflammation and break the itch cycle. These steroid creams are safe and will not cause long-term complications when used correctly over a short duration.
  • If the skin is infected, antibiotics and antiviral medications may be needed. Parents should be reassured that steroid creams prescribed correctly and in short duration will not lead to long term complications.
Subacute or chronic case (the skin is merely dry; no active inflammation present)
  • Maintenance therapy is important to prevent flare-ups.
  • Such therapy include intensive moisturizer creams that are free from fragrance and certain chemicals.
  • The child will also need to bathe with soap-free solutions to prevent excessive drying of the skin.
  • While bathing, make sure the water is not too warm. Dr Melanie nots that water that is too warm tend to worsen one’s eczema.
  • Wet skin should be pat dried gently with a towel.
FEATURED EXPERT
DR JUANI HAYYAN ABDUL KARAF
Consultant Ear, Nose & Throat (ENT) and Head & Neck Surgeon
Sunway Medical Centre Velocity
WILL IMMUNOTHERAPY HELP MY CHILD?

Dr Juani Hayyan Abdul Karaf explains that immunotherapy—in the form of shots—is available to treat allergies, but this is specific for certain allergens such as house dust mites.

WILL MY CHILD CONTINUE TO HAVE ECZEMA WHEN THEY ARE AN ADULT?

Children with eczema can develop food allergy, allergic rhinitis, and asthma—a natural progression from infancy to adulthood known as the atopic march.

Dr Juani shares that the atopic march happens when children continue to develop inter-related allergies into childhood that can begin with eczema.

“It can start with a skin condition as it’s the first body barrier that can be breached. The body’s response can continue and manifest later as food allergies, allergic rhinitis, and asthma,” she elaborates.

More than 50% of children with eczema develop asthma later in life, with a further 33% developing food allergies, as well as an increased risk of developing allergic rhinitis .

CLOSING ADVICE FROM THE EXPERTS
  • “Parents should ensure the child is kept cool as heat can aggravate eczema,” Dr Melanie points out. “Constant round-the-clock moisturizing also does wonders in keeping the child comfortable.”
  • Dr Melanie also discourages the use of antiseptic soaps, as these soaps are harsh and can worsen eczema. “Some parents think eczema is caused by poor hygiene and tend to use antiseptic soaps. However, the more appropriate bathing solution would be something soap-free and fragrance-free and rich in emollients.”
  • Dr Juani advises parents to encourage their child to exercise regularly and spend time outdoors to soak up vitamin D.

Not Sure What Immunotherapy Is? Get Your Answers From an Oncologist!

WORDS LIM TECK CHOON

FEATURED EXPERT
DR HAFIZAH ZAHARAH AHMAD
Consultant Clinical Oncologist
Sunway Medical Centre Velocity
IMMUNOTHERAPY IS A NEWER APPROACH TO TREAT CANCER, BUT WHAT EXACTLY IS IT?

According to Dr Hafizah Zaharah, immunotherapy is a pretty unique way to treat cancer, in that it uses the body’s own immune system to attack cancer cells.

“The immune system is like the police force of our bodies,” she says. “It is designed to protect the body against infections, illnesses, and diseases.”

The cells that make up our immune system. Click on the image for a larger, clearer version.

When it comes to faulty or mutated cells in our body, the immune system identifies and eliminates these cells before these cells become a significant threat to our healty.

However, the cells of our immune system may not be strong enough to kill cancer cells, according to Dr Hafizah. Sometimes, the cancer cells are able to fool our immune system by resembling normal cells or hiding themselves.

THIS IS WHERE IMMUNOTHERAPY COMES INTO THE PICTURE

“Immunotherapy can boost or change how the immune system works, so it can recognize and kill cancer cells,” explains Dr Hafizah.

For example, cancer cells originate from normal cells, so the immune system may still mistake them for normal cells.

“These cancer cells can push a ‘brake’ button on the immune cells, so the immune system would not attack them,” Dr Hafizah adds.

Now, a type of immunotherapy called checkpoint inhibitors can take the ‘brakes’ off the immune system, allowing it to now recognize and attack the cancer cells!

There are other types of immunotherapy, of course, and these treatments can be used for various cancers.

CANCERS THAT CAN RESPOND TO IMMUNOTHERAPY
  • Non-small cell lung cancer
  • Triple negative breast cancer
  • Head and neck cancer
  • Cervical cancer
  • Gastric cancer
  • Oesophageal cancer
  • Bladder cancer
  • Melanoma
  • Liver cancer
  • Renal cell carcinoma
  • Endometrial cancer
  • Colon cancer
WHAT IS IMMUNOTHERAPY LIKE?

According to Dr Hafizah, various immunotherapy agents are given as an infusion into a vein (a drip) typically once every few weeks.

These immunotherapy agents can be given to the patient all by itself, or in combination with targeted therapy or chemotherapy.

“For advanced stage cancer, immunotherapy treatment generally is given for 2 years, alongside close monitoring,” Dr Hafizah further says.

IS IT EFFECTIVE, THOUGH?

Although immunotherapy seems like the answer every person with cancer is looking for, Dr Hafizah warns that not all types of cancers will respond well to the treatment.

This is why, before embarking on immunotherapy, one will first undergo a specific biomarker test, such as the PD-L1 test, which will be carried out on a cancer specimen to ensure that the person will respond to the treatment.

ARE THERE ANY SIDE EFFECTS TO BE CONCERNED ABOUT?

“Generally, the treatment is well tolerated,” Dr Hafizah assures us.

However, just like with most types of treatments, side effects are possible. These include:

  • Feeling tired, skin rash, or muscle or joint pain
  • Rare side effects include allergic reactions such as dizziness, fast heart rate, face swelling, or breathing problems
  • Autoimmune reactions, which can lead to serious problems in the lungs, intestines, liver, hormone-making glands, kidneys, skin, etc

A Quick Primer for Understanding Ovarian Cysts & Uterine Fibroids

WORDS LIM TECK CHOON

FEATURED EXPERTS
DR WONG YEN SHI
Consultant Obstetrician & Gynaecologist
Sunway Medical Centre Velocity
DR FARAH LEONG RAHMAN
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity
DR WONG YEN SHI ON UTERINE FIBROIDS
Click on image for a larger, clearer version.

AT A GLANCE
  • They are non-cancerous growths that form in the muscular layers of the uterus.
  • One can have a single fibroid or multiple fibroids.
  • Often found in women in their reproductive years—that is, the period of time when they are capable of conceiving.
  • We still don’t know what causes fibroids to develop in a woman. Dr Wong states that hormones and growth factors could be possible causes.
YOU MAY HAVE UTERINE FIBROID(S) IF YOU HAVE…
  • Irregular or painful period
  • Heavy bleeding during your period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight gain
  • Painful sexual intercourse

TREATMENT

  • Fibroids can be removed via surgery. Depending on the location and size of the fibroid(s) present in the uterus, this can be open surgery or laparoscopic surgery, the latter involving the use of a laparoscope to make fewer and smaller cuts in the body. Women that no longer want to have children can also opt to have their womb surgically removed.
  • Newer treatments such as uterine artery embolization (blocking the blood vessels that nourish the fibroid, thus causing it to shrink) and high intensity focused ultrasound (HIFU) surgery can be considered, but note that not every medical facility in Malaysia offer these treatments.
  • Medicines to relieve symptoms such as heavy menstrual bleeding and painful period
DR WONG YEN SHI & DR FARAH LEONG RAHMAN ON OVARIAN CYSTS
Click on the image above for a larger, clearer version.

AT A GLANCE
  • These are sacs that contain mostly fluid, sometimes with tissues or blood, which form within the ovaries or on its surface.
  • They are mostly benign, but can be cancerous on rare occasions–especially among women between 60 and 65.
  • Ultrasound and CA125 tumour marker test are used to tell whether an ovarian cyst is benign or cancerous.
  • Conditions such as pregnancy, pelvic infections, and endometriosis can increase the likelihood of developing ovarian cysts. A woman with a history of ovarian cysts is more likely to develop ovarian cysts in the future.
  • Yes, it’s possible to have both fibroids and ovarian cysts at the same time.
YOU MAY HAVE OVARIAN CYST(S) IF YOU HAVE…
  • Irregular or painful period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight change
  • Unexplained loss of appetite
  • Quick sense of fullness while eating
  • Painful sexual intercourse

TREATMENT

  • Smaller cysts usually don’t require treatment. Instead, the doctor will monitor the cyst for signs of growth and other changes. 
  • Larger cysts can be removed via open or laparoscopic surgery.
CAN UTERINE FIBROIDS & OVARIAN CYSTS AFFECT ONE’S CHANCES OF HAVING A BABY? DR FARAH EXPLAINS 
  • Most women with fibroids and cysts have no problems getting pregnant.
  • However, depending on the size and location, uterine fibroids may affect one’s fertility. For example, fibroids that form in the womb lining may block the fallopian tubes, keeping the egg from being fertilized by a sperm cell, or make the womb environment less conducive for a fertilized egg to attach to the womb for further development.
  • Fibroid developing during pregnancy may increase the risk of early delivery. “In some cases, it can cause severe pain when fibroids outgrow their blood supply. If the fibroid is large, it can cause the baby to be positioned wrongly, such as the baby’s head not turning down even at term,” explains Dr Farah.
  • Ovarian cysts forming during pregnancy is usually not a cause of concern, except when the cyst grows so big that it ruptures open.

DR FARAH’S ADVICE

  • Go for regular gynaecology check-up to detect the growths of uterine fibroids and ovarian cysts as well as to ensure that the rest of the reproductive system is in good condition and working order.
  • When you’re about to embark on your pregnancy journey, seek advice from your doctor if you have a history of uterine fibroids and/or ovarian cysts.
  • We still don’t have any evidence-based method to prevent the formation of uterine cysts or ovarian fibroids. However, practicing good health and maintaining a well-balanced diet will be good for your overall well-being and improve your chances of a safe and successful pregnancy.