Female Infertility in Malaysia
Female infertility can determine by evaluation of several factors. Initial assessment looks into the age of the female as a prime-determining factor. Most women over 35 years old are advised to be consulted prior to family planning due to advanced maternal age (AMA) status. If the female partner is AMA, evaluation should be initiated 6 months after unprotected intercourse. Secondly, ovulation status is determined. History of irregular menses may contribute to infertility causes.
Ovulation can be determined by measuring basal body temperatures and response to progesterone, which surges during times of ovulation. Any complications in such responses can contribute to infertility. Ovulatory disorders contributing to infertility include PCOS and decreasing ovarian reserve. Ovarian reserve may be affected by tobacco abuse, radiation treatment, genetic disorders and chemotherapy.
Uterine anatomy is another primary cause of infertility. Ultrasounds, transabdominal or transvaginal, can be used to asses function of the uterus. Women with a history of abnormal uterine bleeding, adhesions or anomalies are more susceptible to infertility. Further imaging such as hysterosalpingography can be used to provide information about the fallopian tubes, which are vital for fertilization. This module of evaluation is most accurate, detecting approximately over 65% of anatomical anomalies in the reproductive organs. History of sexually transmitted diseases is another cause for infertility.
Pelvic infections arise from such sexually transmitted disorders and lead to adhesions, scarring uterine and fallopian tissue, making it a less viable environment for ovulation and fertilization to occur. Lastly, there can be non-identifiable causes for infertility, further adding to the crisis. With time and medical advances, hopefully women suffering from unknown etiologies can be better managed with emerging treatments.