Fertility Forum :

by Dr Agilan Arjunan, Fertility Specialist, KL Fertility Centre ( Malaysia)


KLF Forum IUI or IVF-Dr Agilan

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Fertility for Cancer Survivors


by Dr Agilan Arjunan



The month of October is dedicated for cancer awareness.

Pink October is a month for breast cancer awareness. There is considerable media attention on the issue of breast cancer and breast cancer survivors .

Thus, it is appropriate and also essential to dwell into a topic so important to all cancer survivors, yet seldom discussed, which is their fertility health preservation. Cancer treatment, specially chemotherapy, can potentially lead to sterility due to its effects on the gonads ( ovaries and testicles).

In recent years, we are seeing more cancer survivors , thanks to the advancement in diagnosis and treatment of all types of cancers. Many childhood and young cancer survivors live through their adulthood and their need to start a family warrants attention.

Typically, the discussion about any fertility preservation technique for a patient starts with their oncologist. The issue becomes more complicated if the patient is a minor. In this situation, parents usually decide in the best interest of their child after discussion with their oncologist and fertility specialist.

The suitability of each methods of fertility preservation depends on the type of cancer, the treatment regime, the time interval between diagnosis and treatment and the status of sexual development of the patient (i.e pre-pubertal vs post-pubertal).

Post-pubertal boys / Young adults

In post-pubertal boys and young adults, the most established method of fertility preservation is cryopreservation of their sperm . This is simply known as sperm freezing. Sperms that are frozen can be kept in liquid nitrogen for many years. Once the patient had overcome his struggles and ready to start a family, his sperm can be thawed and with the assistance of reproductive techniques , he can realise his hope of have his own child.

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Myths of Miscarriage :A Pregnancy Scare

by Dr Agilan Arjunan


Knowing the myths of miscarriage

“ I lost my baby because I was walking too much”

“ It’s all my fault, I should have just stayed at home”

These are some of the examples of what couples think about their miscarriage. In the practise of a gynaecologist and fertility specialist, miscarriage is one of the most difficult situation to deal with. The difficulty is not posed by the medical treatment that are needed in such a situation but by the ‘emotional’ treatment that a couple needs. The ‘emotional challenge’ lies in treating their perception of why they lost their baby. It is even more stressful if the couple had conceived after a fertility treatment (IVF / ICSI).

About 1 in 6 pregnancies will end in a miscarriage. This risk increases with the age of the women and less commonly with the age of the male partner. Thus , the risk of miscarriage is higher for an older couple than a younger pair.

Here are the myths about miscarriage that couples ought to know.

  1. Miscarriage is rare.

      Even in a younger couple ( < 35 years old)  , close to 20% will lose their pregnancy. Many lose their pregnancy during their first 12 weeks . In majority of cases, nothing can be done to prevent this because most of the miscarriages are due to genetic problems of the unborn baby. The miscarriage occurs as part of the human’s body quality control process.

2. Miscarriage is due to stressful events and lifting heavy objects.

    Once a woman is pregnant, she is often asked not to do anything except rest. Lifting any heavy objects is a big NO NO. The truth is, there is very little evidence supporting this idea. Most of the miscarriages are due to genetic problems of the foetus rather than physical exertions. Common stressful events such as death of a family member or even stressful events at work are not the reasons for miscarriage.

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