Entry posted by A Yagnya, Assistant Director
In Singapore, the total fertility rate (TFR) – which measures the average number of children that a woman would bear in her lifetime – has fallen to an all-time low of 1.16. This is way below the replacement level of 2.1.
Unfortunately, this state of affairs is one seen in many developed countries. “As the population becomes more educated, there is a change of values and priorities. Career achievements and lifestyle desires take precedence over other issues. Starting a family takes a backseat and having children is seen as a sacrifice,” explained Dr Loi.
Then there’s the question of fertility.
Fertility problems may arise due to problems in either the female or male reproductive systems, or sometimes in both.
FACTORS BEHIND DROPPING BIRTHRATES IN SINGAPORE:
With Singapore’s economic success, more and more couples are putting their career first, marrying later and starting their family at an older age compared to their parents’ generation.
2. Work Life balance
Social economic factors also play a part. With a busy work schedule, increasingly couples may find less time to spend with each other or may be too tired after work to try to conceive during their fertile period. Sometimes one partner is not even in Singapore because of work commitments.
Housing is also a factor. Most couples are unwilling to start a family unless they can find a place of their own to stay once they are married and with high property prices, many are delaying marriage and starting a family until they can afford a home.
Lastly with better education and a higher standard of living, many young Singaporeans are also getting increasingly more particular about choosing their life partner which in turn leads to more unmarried singles amongst our population.
All of these mentioned developments are contributing to Singapore’s low birth rate.
WHAT CAN BE DONE:
SOMETIMES, nature needs a little help from science when it comes to making babies. And in Singapore, the number of babies arriving with the aid of technology is burgeoning. In 2009, 1,158 babies were born of mothers who used Assisted Reproduction (AR) treatments. That is an eye-popping 44 per cent jump from the 802 babies born this way in 2007, the year MOH started tracking these figures.
Is youth really a factor in fertility?
It is certainly true that younger women have a better ovarian reserve i.e. better number of healthy eggs, and are less likely to have problems conceiving. But they may also encounter difficulty if they have had multiple sexual partners previously and suffered from sexually transmitted infections resulting in blocked fallopian tubes.
What are the best ways for a couple to improve their fertility and their chances of conceiving?
They should start trying for a family as soon as they are ready as age has a major impact on the success of fertility treatment. A healthy diet and lifestyle are always beneficial.
• Maintain a normal weight, exercise and eat a diet rich in fruits, vegetables and antioxidants
• Stop smoking – smoking impairs sperm quality and female smokers are 1.6 times more likely to be infertile
• Limit alcohol intake to two drinks per day
• Use lubricants (if they use them) which will not hinder conception
• Limit coffee intake to one cup a day; high levels of caffeine are associated with decreased fertility and an increased risk of miscarriage
• Take folic acid to prevent certain birth defects
• Wear loose-fitting undergarments
• Avoid extremely hot temperatures, such as hot tubs or saunas
What are the chances like for women over 35 to conceive and give birth to a healthy baby?
The likelihood of conceiving falls from 20% a month in a woman’s late 20s to 8% in the late 30s. The likelihood of conceiving in one year falls from 86% to 65% respectively. Even the success rate of artificial reproductive treatment is not spared and pregnancy rates fall with increasing age from over 40% in women less than 35 years to just 10% in women over 40 years.
Women under the age of 35 years have about a 15% chance of miscarriage while those 35-45 yrs old have a 20-35% chance of miscarriage. As the risk of foetal abnormalities increases with age, it is important for women to see an obgyn early in their pregnancy and to undergo the various antenatal screening investigations available if they wish to know their risks.
What’s your take on alternative therapies for fertility?
Stress may play a part in affecting fertility, especially if it leads to tiredness and a decreased libido. So couples should look into their own lives to find time to give their minds and bodies a respite from the stresses of daily life. If they feel more relaxed and happier, they will be healthier overall and that may certainly help them become more “productive”. So as long as the alternative therapies help reduce their stress levels, they may be beneficial in that sense.
Our Assistant Director, Yagnya gives her personal take on this issue:
Looking through a lot of information on the internet, the newspapers and also speaking to people I’ve known, there are MANY situations in which couples or individuals might want children and are unable to have them. Sometimes, it’s age, sometimes its a medical problem with either the man or the woman, sometimes it’s marital status or even sexual orientation. Whatever the case, the fact that they want a child but can’t have one does not make the situation any less painful. Especially with so many campaigns going on to encourage couples to have children, there would be this constant reminder of your inability. I can’t begin to imagine how painful it must be for many of them.
But the world we live in today is advancing in terms of technology. Things that we thought of as impossible several years ago is a norm today. So I’d like to think that despite all the challenges that many of these couples face, even if there might be no way to help them now, there will always be something new coming up in the next year or two. SOMETHING to give hope.
We’re at a stage in life where we are being presented with so many options and there’re no one right way of going about it. If reproductive surgery doesn’t work out there’s IVF or AI. If that doesn’t work out, there’s surrogacy. If THAT doesn’t work for you, there’s adoption. One look into a the internet and more than one option turns up. People can choose the method that suits them best.
While most heterosexual couples might prefer natural reproduction, I like to think of these methods as aids to those who are unable to have the children they want. It might take them a longer time to have a child, but hey, at the end I’m sure the child would prove to be worth the wait if the try various methods and prove to be successful.