Don’t wait until you’re ready to try for infertility; you risk having more difficulty conceiving than you think! The show “MY DADDY James” reveals the truth about infertility, which doesn’t just affect women, but even seemingly healthy men can have problems without realizing it. It explores the trend of egg freezing and techniques for restoring egg quality, showing that even with only one egg, pregnancy is possible. The show also covers saving couples before their families fall apart, with Dr. Mon Matchuphorn, a specialist in reproductive medicine and infertility treatment from NIC IVF CLINIC. She shares a case study of someone who tried 27 times and almost gave up, but finally became parents at the age of 45.
How can infertility be checked?
Dr. Mon: Infertility is only considered when couples are married, because it requires the combination of sperm and egg. This means they must be married and have regular sexual intercourse (2-3 times a week) without contraception for a year. If they don’t conceive within that time, they are diagnosed with infertility. The exception is some women with pre-existing conditions like endometriosis or polycystic ovary syndrome (PCOS). If a woman has a pre-existing condition that might make it difficult to conceive, it’s recommended that if she hasn’t conceived in six months of marriage and has a pre-existing condition, she should consult a doctor. That’s the definition of infertility.
The initial screening, without any tests yet, involves continuing with your daily routine. If nothing unusual happens, it means you might be in the category of those who tested positive.
Dr. Mon: Yes, because actually, the chance of getting pregnant within one year is 85% if there are no problems. Actually, when we do infertility checkups, we test both men and women. This is because most men don’t have any symptoms and tend to think there’s no problem. But women are more aware. Nowadays, women are getting married later, so they start to worry about whether their eggs have problems or if there’s something wrong with their bodies. But really, both partners need to be tested.
What is a normal level of ovarian hormone levels?
Dr. Mon: At different ages, the AMH (Acute Ovary Humidity Hormone) levels will vary, perhaps every 10 years or 5 years. The values will differ between a 30-year-old and a 42-year-old. The Rotterdam criteria defines an AMH level (Acute Ovary Humidity Hormone) of less than 1.1. Generally, regardless of age, the AMH level has more specific age-related criteria for removal, which I think is too detailed. But for women to remember simply, if the AMH level is below 1.1, it indicates ovarian dysfunction. And if you are over 35, meaning both ovaries combined have less than 5 follicles (left and right), it’s considered ovarian dysfunction.
What are the current trends in egg freezing?
Dr. Mon : It’s become very common. When I first graduated, there were hardly any patients coming in to freeze their eggs here. I graduated from Weill Cornell Medical College in New York, America. While I was there, I was amazed because I saw women coming in to freeze their eggs every day. I’d ask them what they were studying, and they’d say they were going to get a PhD. A PhD in America takes another five years, and they don’t plan to have children while studying. They realized they should freeze their eggs while they’re young, and then have children later after graduating. For example, if you graduate at age 40, and you freeze your eggs at age 35, they’ll still be at age 35, even if you thaw them at age 40. There were women who hadn’t even graduated yet, and women who hadn’t found a husband, coming in to freeze their eggs every day. Then, when I came back to Thailand, there were none. In the first year, there were only about 1-2 people per year – very few – because nobody was promoting egg freezing. It was like women didn’t even know this technology existed. But after almost 10 years, now we have more patients freezing their eggs in some days than those doing ICSI or IVF. But the people who really come are those who have realized the importance of it themselves. Many women who are in relationships but don’t want children yet are freezing their eggs.
What is the ideal age to freeze your eggs?
Dr. Mon: It’s available for all age groups. Even up to 47, people are still considering egg freezing. For example, this woman recently got a boyfriend, but he’s almost 10 years younger. So, initially, she had no idea about egg freezing. We discussed it, and she replied that it was okay because she didn’t have a boyfriend yet. Then, one day, she found a younger boyfriend, and so she wanted to have children, so she started freezing one egg per month. I really want women to be aware that they should freeze their eggs, like getting life insurance – whether you use it or not is irrelevant. But you can put it on your profile: “I have frozen eggs. When I was single and swiped right (on Tinder), I wanted to have children, and I had frozen eggs.” It’s a profile for men to choose from, based on the appropriate age group for egg freezing. I recommend before 35. Currently, I see women in the 31-35 age range, but I see more often those over 35 because the technology only boomed towards the end of its life. So, some women in their 40s also want to freeze their eggs. At least they’ve asked for it. But we have to tell them that they might need several stimulation cycles to get a sufficient number of eggs to have children.
What types of problems warrant immediate egg freezing?
Dr. Mon: People with ovarian problems experience symptoms like hot flashes, irritability, and insomnia – these are symptoms of menopause, indicating that hormone production is almost non-existent. Secondly, there are people with endometriosis (chocolate cysts) or ovarian cysts. Sometimes, they’ve had surgery, and in that case, they lose a significant portion of their ovarian tissue compared to healthy individuals. Therefore, there’s a tendency for ovarian function to decline after biopsy. So, if you know you’ve had surgery to remove your eggs, or if you’re experiencing symptoms of ovarian decline, please come see us immediately.
What constitutes optimal sperm quality?
Dr. Mon: Regarding sperm quality, as James mentioned, he was overly confident. When the test results came back, he was shocked because he exercised too much every day. Life needs to be balanced. So, when we look at sperm parameters, there are three simple things, according to the World Health Organization: 1. Sperm concentration – the quantity needs to be high enough, which is more than 16 million. 2. Even if there are many sperm, if they don’t move, it’s over. Therefore, we need to look at the motility of the sperm. Grade A sperm that move quickly, because they have ABCD structures, should be more than 42%. Finally, those that move well but have damaged heads, missing tails, or have two heads or three tails, won’t be able to fertilize. We only consider about 4% of those with incomplete morphology. So, if these three parameters are normal, you’re considered to have passed.
Does hair growth medication really destroy sperm?
Dr. Mon: What I see very often now are people taking hair growth medication. Teenagers are getting hair transplants at a young age. Therefore, when people take hair growth medication, they have to take Finasteride and Minoxidil, which are anti-androgens, substances that counteract male hormones. Because of this, they also destroy sperm. In many cases, out of 10 I test, I find about 8 have had hair transplants. I ask them if they’ve been taking medication. But luckily, if they stop taking it for about 2-3 months, their sperm will return. Then, after collecting the sperm and completing IVF, they can go back to taking the medication.
Does lack of sleep, stress, and partying affect sperm?
Dr. Mon: Actually, it’s possible because of ROS (Reactive Oxygen Species), an oxidative stress that destroys sperm. It’s damaged by white blood cells. Rest and lack of sleep all affect it, but it doesn’t usually destroy sperm to the point where it drops from 15 million to 1 million. It’s usually just minor abnormalities here and there. Meaning, if they recover and rebuild, they can return to normal. But if there’s a truly severe abnormality due to an underlying disease, like Klinefelter syndrome (a chromosomal abnormality that causes infertility), or patients who’ve had mumps (where mumps affects the testicles, causing swelling and inflammation), it destroys all the sperm. Or some diseases with Chlamydia infection causing testicular inflammation, where the testicles show zero sperm, also resulting in infertility. However, there are different types: some where sperm can still be detected from the testicles, and others where there are no sperm at all.
Can people with endometriosis (chocolate cysts) or cancer stimulate ovulation?
Dr. Mon: Egg stimulation is possible, but for those with endometriosis (chocolate cysts), we need to consider the test results. If the values aren’t too low, egg stimulation and retrieval are still possible like for normal people. However, the egg quality in the group with endometriosis is generally not very good. For those with cancer, I recommend egg freezing. If you’re married, you can proceed with infertility, doing ICSI to store embryos, and then wait for the cancer to clear before transferring them. For unmarried women, egg freezing is the best option. Actually, it’s now a guideline that all oncologists should offer patients the option of having children before starting treatment by freezing or storing embryos. Egg stimulation only takes about 10 days, and then egg retrieval can be done immediately. Therefore, cancer treatment isn’t delayed or postponed until the disease progresses from stage 2 to stage 3. That’s not the case. So, patients can store their eggs beforehand and then, after recovery, use the embryos to have children. I’ve seen many couples who were very happy that their oncologists recommended this. Because if you don’t do it beforehand, chemotherapy will destroy all the rapidly dividing cells in the body, including hair cells and egg cells. These will all die, as well as sperm. If the man receives chemotherapy.
Does pre-egg retrieval stimulation affect the body and hormones?
Dr. Mon: If a woman has good hormone levels, towards the end of ovarian stimulation, around days 8-10, she might start experiencing symptoms similar to bloating because the eggs are growing. If hormone levels are good, it means she already has a large number of eggs. Imagine a abdomen full of tadpoles, each about 17-20 mm in size, about 10 on each side. The patient will start feeling bloated, abdominal discomfort, abdominal pain, or have mucus discharge from the vagina, which is estrogen-related mucus. However, if a woman has a low egg count or is in the group with ovarian dysfunction, she might experience almost no symptoms after stimulation because only 3-4 eggs have grown, which is close to the normal state where the body already has one growing egg. Therefore, the severity of symptoms depends on the number of eggs present.
How to keep male sperm healthy?
Dr. Mon: For men, it’s really just about adjusting smoking, alcohol consumption, and sleep. What we often see in overweight men is what some call “sleep apnea,” where the tongue falls back during sleep, reducing blood oxygen levels and causing a temporary cessation of breathing without them realizing it. Some men snore, but others don’t; it’s a different condition. They need to undergo a sleep test to see if they have sleep apnea—the periods of breathing cessation caused by the tongue obstructing the airway. This can affect sperm quality. If the test reveals weak sperm, the patient might need a CPAP machine to help pump oxygen, and then sperm quality will gradually improve. So, men can actually improve their sperm quality quite easily. The vitamins commonly recommended are zinc, selenium, and biotin, which can help improve sperm quality to some extent. But the main thing is lifestyle changes. Exercise is also important; don’t overdo it, because whenever the testicular temperature rises by even 1-2 degrees Celsius, sperm production decreases.
What advice would you give to someone who is planning to have children?
Dr. Mon: Based on my experience, I’d like to advise couples planning to have children that, as is true, people are having children later in life. Many people think they’re not ready yet, whether it’s because of work, housing, finances, or waiting for everything to be perfect. But let me tell you, in reality, there’s no such thing as being 100% ready. Therefore, once you’re married or planning to get married, I recommend getting checked together as soon as possible – both sperm and ovarian hormone tests. This doesn’t necessarily mean you have a problem; it’s simply a way to check your health and see if you’re actually doing well. You can wait until you’re fully ready to have children if you want. However, if you find out your hormone levels are declining, you might need to undergo more complex treatments, such as multiple ICSI cycles, which is more time-consuming and expensive than taking care of your health when you’re ready. So, I urge all couples not to wait a year to consult us. The age at which people get married and have children is increasing. Whether you’re a woman who wants to freeze your eggs or a newly married couple who is older, you can come in for a consultation anytime.
