Conceiving with Care: Using fertility medicines the right way
In Malaysia, the total fertility rate (TFR) fell to 1.73 children per woman in 2023, far below the population replacement rate of 2.1.
The lower fertility rate is commonly associated with reduced population growth and can be attributed to various social, economic and health-related influences, including greater educational attainment, increased workforce participation especially among women and evolving perceptions of ideal family size.
DEFINITION AND CAUSES FOR INFERTILITY
The World Health Organisation (WHO) defines infertility as the inability to conceive after one year of regular, unprotected sexual intercourse. Infertility can affect both women and men, and there are several possible causes, including: Ovulation disorders, which may be due to polycystic ovary syndrome (PCOS), hormonal imbalances, or previous ovarian surgery
Blocked fallopian tubes, often resulting from sexually transmitted infections, or endometriosis
The presence of cysts or fibroids within the uterine cavity
Abnormal or poor-quality sperm caused by congenital abnormalities, or hormonal issues
Infections in the testicles, undescended testicles, or varicocele (enlarged veins in the scrotum)
Excess body weight
Smoking habits
Frequent exposure to radiation or harmful chemicals
But, in some cases, infertility has no identifiable cause and is classified as unexplained infertility.
COMMONLY PRESCRIBED MEDICINES FOR INFERTILITY
Fertility medicines such as clomiphene, gonadotropins and bromocriptine are frequently prescribed by doctors to act like the body's natural hormones, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
These medicines are primarily indicated for the treatment of infertility in women, especially in cases involving ovulation disorders. They help to produce better quality eggs or increase the number of eggs released.
However, not all infertility cases can be treated with medicines alone. Certain conditions, such as blocked fallopian tubes, structural abnormalities or severe male factor infertility, may require other interventions like surgery or assisted reproductive technologies.
Although there are several medicine options available to help with infertility, patients should not take them without a doctor's advice. Taking these medicines without supervision from a healthcare professional can be harmful to the patient.
Like other medicines, fertility medicines can cause side effects too. Thus, their use must be closely monitored to minimiSe the risks.
For example, clomiphene is commonly used as the first line treatment to induce ovulation. However, it may still cause side effects such as hot flashes, mood swings or the development of ovarian cysts if not taken correctly.
Gonadotropins, which are given as injections to stimulate the ovaries, carry the risk of ovarian hyperstimulation syndrome (OHSS). This condition can potentially be serious and causes the ovaries to become swollen and painful.
Another medicine, bromocriptine, is used to lower elevated prolactin levels that can disrupt ovulation and lead to infertility. However, it may cause side effects such as dizziness, headaches, vomiting or constipation. A mother looks after her newborn baby in hospital in Nantes, western France, on July 8, 2018. (Photo by LOIC VENANCE/AFP)
ADVICE FOR INDIVIDUALS WITH INFERTILITY
The journey to conceive can be challenging and requires patience for some couples. Therefore, those considering fertility treatment should seek accurate information and proper guidance from qualified healthcare professionals.
For example, Hospital Tunku Azizah offers a Fertility Medication Therapy Adherence Clinic, which provides comprehensive care and personalised treatment plans to improve fertility outcomes. The clinic is managed by pharmacists working closely with a multidisciplinary team of healthcare professionals.
Working with specialists can help identify the most appropriate treatment based on an individual's medical history and health condition, ultimately increasing the chances of conception.
In addition, couples are encouraged to undergo a comprehensive health screening to ensure they are in optimal health before starting fertility treatment. During the course of treatment, regular health check-ups are essential to ensure the process proceeds smoothly.
Patients who have been prescribed medicines for infertility treatment should take them according to the instructions and advice provided by their doctor or pharmacist. Incorrect usage such as taking the wrong dosage, using inappropriate combinations, or not following the recommended schedule can reduce the effectiveness of treatment, increase the risk of side effects, and potentially cause long-term health complications.
Some people turn to over-the-counter supplements like folic acid, vitamin D or antioxidants in the hopes of boosting fertility. However, scientific evidence supporting their effectiveness remains limited. These supplements may benefit overall health, but they should not replace medical treatments or be relied upon as the sole solution for fertility issues.
Couples are also encouraged to adopt a healthy lifestyle by maintaining a balanced diet, exercising regularly and getting adequate rest. They should also avoid habits that may affect fertility such as smoking and excessive alcohol consumption.
Psychological support from a partner, family or friends, as well as counselling sessions, can help patients cope with the stress that may arise during the treatment process.
In conclusion, although infertility can be a complicated and emotionally challenging experience, it is important to remember that help is available. With the right treatment and proper use of prescribed medicines under professional care, many couples have found renewed hope and meaningful progress in their fertility journey.
If there are any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free number 1-800-88-6722 during weekdays from 8 a.m. to 5 p.m., except on public holidays.
Prepared by Syafi'ah Bakaruddin, Pegawai Farmasi UF12, Klinik Kesihatan Putrajaya Presint 9, Pejabat Kesihatan Putrajaya. She can be contacted at syafiah.b@moh.gov.my.
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FERTILITY struggles are becoming more common, affecting around onein sixcouples. In Malaysia, the total fertility rate (TFR) fell to 1.73 children per woman in 2023, far below the population replacement rate of 2.1. The lower fertility rate is commonly associated with reduced population growth and can be attributed to various social, economic and health-related influences, including greater educational attainment, increased workforce participation especially among women and evolving perceptions of ideal family size. DEFINITION AND CAUSES FOR INFERTILITY The World Health Organisation (WHO) defines infertility as the inability to conceive after one year of regular, unprotected sexual intercourse. 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Couples are also encouraged to adopt a healthy lifestyle by maintaining a balanced diet, exercising regularly and getting adequate rest. They should also avoid habits that may affect fertility such as smoking and excessive alcohol consumption. Psychological support from a partner, family or friends, as well as counselling sessions, can help patients cope with the stress that may arise during the treatment process. In conclusion, although infertility can be a complicated and emotionally challenging experience, it is important to remember that help is available. With the right treatment and proper use of prescribed medicines under professional care, many couples have found renewed hope and meaningful progress in their fertility journey. If there are any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free number 1-800-88-6722 during weekdays from 8 a.m. to 5 p.m., except on public holidays. 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