Jolly good time to procreate

Jolly good time to procreate

It is that time of the year again... to make babies, it seems.

Figures released by the Immigration and Checkpoints Authority show that about 9 per cent more babies were conceived monthly from December to February, compared with the monthly average for the rest of the year.

From 2004 to last year, the highest number of live births recorded here were for the months of September, October and November.

Given that most pregnancies last nine months, the women likely fell pregnant from December to February - regarded as a festive period which spans major holidays such as Christmas, New Year, Chinese New Year and Valentine's Day.

An average of 35,020 babies were born in each of these three months during the 10-year period.

This is in contrast to the average figure for each of the rest of the months, which was markedly lower at 31,868 babies.

Dr Jazlan Joosoph, a member of the advisory panel of the SG50 Baby Jubilee Gift initiative, said the trend suggested by the data did not surprise him.

"During this period, couples or families usually go on vacations, which are good times for procreation," said the obstetrician and gynaecologist at Raffles Women's Centre.

"A good year-end bonus and a healthy income may also enhance the decision to build a family."

More importantly, couples may feel less stressed, making it more conducive to have babies, he added.

Despite that, Singapore's total fertility rate fell from 1.29 in 2012 to 1.19 last year. Both figures are below the replacement rate of 2.1 births per woman.

If you are thinking of having a little one, here are some handy tips from the experts.

1. Calculating when ovulation occurs

For women with regular periods, the old-school method of using the calendar to track one's fertile period is fairly reliable, said Dr Joosoph.

There are now mobile apps and online calculators to help with this.

Typically, ovulation occurs around the 14th day for women with a regular 28-day cycle, said Dr Irene Chua, a senior consultant obstetrician and gynaecologist at Gleneagles Hospital.

One can also try using a home ovulation test kit, which can be bought at pharmacies. This measures the surge of luteinising hormone in the urine that indicates ovulation, said Dr Chua.

Or, go for hormonal blood tests and ultrasound imaging to monitor the development and maturation of dominant follicles in the ovaries, and to measure the thickness of the uterine lining, said Dr Joosoph.

2. Diet and lifestyle habits

Smoking and drinking too much alcohol can affect fertility in both men and women, said Dr Chua.

For instance, the risk of infertility among smokers may be twice that of non-smokers, with women smokers at least 11/2 times more likely to take longer than a year to get pregnant.

Maintaining a healthy weight is also important for men and women.

A study in Denmark on 1,600 young men showed that those with a body mass index (BMI) exceeding 25 - which is considered overweight - had sperm concentrations that were about 22 per cent lower than in men of a healthy weight. Similar results were seen in underweight men.

Meanwhile, women who are severely underweight or overweight tend to have irregular periods, which suggest inconsistent or a lack of ovulation, said Dr Joosoph.

3. Exercise

Regular physical activity can keep one's weight and health in check which, in turn, helps to boost one's chances of becoming pregnant and having good pregnancy outcomes.

Malnourished mothers are more likely to miscarry or give birth to smaller babies, said Dr Kelly Loi, an obstetrician and gynaecologist at Mount Elizabeth Hospital.

Research has shown that babies with low birth weights of less than 2.5kg are at higher risk of chronic ailments, such as diabetes, later in life.

Maternal obesity, on the other hand, may result in a higher risk of gestational diabetes, hypertension and heart disease, said Dr Loi. For the baby, there is an elevated risk of birth defects, stillbirth and chronic diseases when he gets older.

In general, pregnant mothers should avoid high-impact activities such as fast-paced running or heavy-weight-lifting. "Such exercises can overstrain the joints, which are already 'loosened' by the pregnancy hormones in the body," said Dr Loi.

Expectant mothers should also avoid activities that may throw them off balance or fall down, she added. Suitable options include walking, swimming and pilates.

A note of caution - exercise may not be suitable for every pregnant mother. Check with your doctor first.

Women who are trying to get pregnant, on the other hand, may want to think twice about embarking on extreme exercise regimens, which may affect ovulation, said Dr Chua.

4. Pre-pregnancy check-up

Some key tests for couples include those for blood group, to detect incompatibility between the couple; for infections, such as hepatitis B and HIV, and immunity against certain conditions; and a full blood count to screen for blood disorders, said Dr Joosoph.

A pelvic exam and ultrasound scan are also useful in determining if the woman has conditions such as uterine fibroids or ovarian cysts, which may require treatment, said Dr Loi.

Ideally, pre-conception screening should be done three to six months before conceiving, so that there is time for important vaccinations to be done before pregnancy, she added.

While some genetic screening is routinely done as part of pre-natal assessments, couples with risk factors or a family history of genetic diseases may be advised to go for further tests and be referred to a genetic counsellor, said Dr Loi.

5. Manage stress

Stress is said to be responsible for up to 30 per cent of infertility issues.

In fact, our bodies are equipped to prevent conception from occurring in times of extreme stress, pointed out Dr Chua. "The presence of adrenalin, a hormone released during stressful times, signals to our body that the conditions are not ideal for conception," she said.

Indeed, recent research has shown that stress can suppress ovulation in women, sexual activity and sperm count in men.

"Chronic stress may cause lack of libido as well as a decrease in one's general fertility," said Dr Chua. "This has become so common that there is now a name for it - stress-induced reproductive dysfunction."

When one starts to experience symptoms constantly, such as feeling worried all the time or having difficulty concentrating on tasks, it may be wise to visit a doctor, said Dr Loi. "These could be signs of depression or an anxiety disorder, and should be treated right away."

chpoon@sph.com.sg

COMMON MISCONCEPTIONS

Contraceptive pills, when taken in the long-term, cause infertility.

This is not true. Age is, in fact, one of the biggest risk factors for infertility.

It could be that those who had been on the pill for a long time simply became too old to get pregnant when they finally came off it, suggested Dr Jazlan Joosoph, an obstetrician and gynaecologist at Raffles Women's Centre. "They then conveniently blame their fertility troubles on the innocent pill."

If a woman is still fertile, ovulation can resume as early as the following cycle after she stops taking the pill.

Men do not have a "biological clock".

Although the clock may tick more slowly for men, getting older does affect their fertility, said Dr Kelly Loi, an obstetrician and gynaecologist at Mount Elizabeth Hospital.

Older men are more likely to encounter fertility problems due to declining testosterone levels, a decrease in the quality and quantity of sperm, and a higher risk of getting other medical problems.

The more frequent the sex, the better the chances.

Studies have shown that sperm count drops with daily or frequent ejaculation.

Furthermore, it is not necessary to get intimate every day, as the egg can survive for 48 hours after being released, while the sperm remain viable for up to 72 hours, said Dr Joosoph.

The general advice is to have sex every other day during a woman's fertile period.

You are more likely to experience fertility challenges if you are a "first-timer".

Secondary fertility is actually a fairly common problem, said Dr Loi. This is where couples have trouble conceiving even after they have successfully done so before.

Some studies indicate that secondary infertility is the reason for 50 to 60 per cent of couples seeking fertility treatment.


This article was first published on Dec 25, 2014.
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