Have you and your spouse been trying year after year for a baby without success? Perhaps you’ve both tried everything to improve your fertility health and optimise your chances of having a baby, but it just hasn’t happened yet.

Don’t be discouraged.

Dr Veronique Viardot-Foucault, Celine, Senior Consultant at the Department of Reproductive Medicine, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group, is here to help.

Question by deanna

Besides leading a healthy lifestyle, are there any particular foods or supplements that can help with fertility, both for the man and woman?

Answered by Dr Veronique Viardot-Foucault:

Couples who are planning to conceive should adopt a healthy lifestyle that includes having a healthy and balanced diet, stopping or limiting alcohol and caffeine intake, stopping smoking, and maintaining a healthy body mass index. The woman should also take folic acid supplements.

Question by vivian89

One common piece of 'advice' that I have heard from people to increase chances of conception is for the woman to put her legs for a couple of minutes after sex. Does this help at all or is it pointless? Is there anything that can be done to facilitate the sperm’s journey?

Answered by Dr Veronique Viardot-Foucault:

There is no evidence to show that specific sexual positions can increase the chances of conceiving. However there is evidence to show that timing your sexual intercourse close to the time of ovulation will increase chances of pregnancy. Couples planning to conceive should have regular sexual intercourses, at least twice or thrice per week.

Question by olivm

Hi Doctor, If I have PCOS and I am doing IVF, are there aspects of my IVF cycle that will be different due to my diagnosis of PCOS?

Thanks in advance!

Answered by Dr Veronique Viardot-Foucault:

Patients affected by polycystic ovary syndrome (PCOS) tend to have more follicles (a follicle contains the egg) in their ovaries. Therefore, when an ovarian stimulation is given in context of IVF, you might experience abdominal discomfort and nausea due to the development of a large number of follicles. During your ovarian stimulation, you should drink one to two litres of water per day and consume more protein. For further advice, please consult your fertility specialist.

Question by 7alice

Hi Dr Veronique, I am trying for my first baby at the age of 42 this year. I am underweight, my BMI is 18 and my menses is irregular. I have done multiple IVFs, which have all failed.

What can I do and are there any alternatives to solve this problem? How can I increase my chances of conceiving at my age?

Many thanks for your advice!

Answered by Dr Veronique Viardot-Foucault:

A BMI between 18 to 23 is considered normal. Many factors are necessary to assess a woman's fertility potential. Some factors are patient-related, such as age and egg reserve count. Some factors are related to the type of ovarian stimulation protocol used and the response of your ovaries to treatment. If you have already undergone several treatment cycles, I would advise you to seek further advice from a specialist (with your detailed history) to evaluate your future chances of conceiving.

Question by Sandra_

Dear Dr Veronique,

I'm 33 and have been trying for a baby for 2 years. My husband and I exercise regularly, we eat healthy but we haven't had any luck. Meanwhile our siblings they eat all kinds of hawker foods, are overweight, and they have 2 healthy babies. We also have friends who still party and drink and smoke and still can have babies. Cute and healthy some more.

Is there really a correlation between being healthy and conceiving & having healthy babies? Or is it all in the mind?

Answered by Dr Veronique Viardot-Foucault:

Couples who are planning to conceive should adopt a healthy lifestyle that includes having a healthy and balanced diet, stopping or limiting alcohol and caffeine intake, stopping smoking, and maintaining a healthy body mass index. The woman should also take folic acid supplements. You and your husband may wish to seek a further assessment with a fertility specialist.

Question by gole5

Hi Doctor Veronique,

So many people tell me I shouldn’t feel stressed if I want to have a baby but it is.

We’ve tried many things – IUIs, multiple gynae consultations, babymoons. It doesn’t help that different doctors say it’s going to be even harder for me to conceive if I wait (as if I want to wait) longer. I’m 36 this year and we’ve been trying for 3 years.

On top of that, I have a toxic boss. I’m concerned that if she knows I’m trying for a baby, she will give me even more work. (because she has done that before)

Now my husband and I are discussing whether I should quit my job so we can have a baby. Do you think the absence of a toxic boss can help us conceive? Nobody in my department has had a baby in 5 years.

Answered by Dr Veronique Viardot-Foucault:

A balanced work-life is often required to improve one’s fertility potential. If your current situation does not satisfy you, you might need to consider an alternative that may suit you better.

Question by esther

Hi, I have been married for almost a year. But till now, whenever trying for a intercourse with my husband, it feels painful during penetration. Because of my pain, we never had a successful penetration till now. Is this normal? Is it a pain i need to endure for the first time? Is there anything I can do to overcome the pain? Appreciate your advise. Thanks!

Answered by Dr Veronique Viardot-Foucault:

It seems that you are experiencing intercourse pain, or medically known as dyspareunia. Pain during intercourse can affect a couple’s relationship. Please consult a fertility specialist to better determine the cause as well as management and treatment options.

Question by mello

Hi Dr. Veronique! My husband and I went for a fertility check and apparently I am not ovulating enough while my husband has low sperm count. I will be going on Letero next month while he will be taking Tradafertil.​

1. May I know usually how long these medication will take to take effect?
2. We have been trying for about 5 months. Apart from the abovementioned medication, are there other ways to boost sperm count?
3. I track my ovulation religiously and all the Clearblue ovulation test kits do show days leading up to ovulation as well as the actual day of ovulation every month since May this year. As I am terrified of needles and I do get sleepless nights before jabs, could it have caused the blood test results to be askew? Are OPKs really "useless", as mentioned by my gynae? Thank you for your advice! :)

Thank you for your advice! :)

Answered by Dr Veronique Viardot-Foucault:

1. May I know usually how long these medication willl take to take effect?

If the sperm count is low, any medication taken to try to enhance the sperm count will take about three to six months to be effective.

To stimulate ovulation in women, drugs can be taken. The usual duration of ovulation-stimulating drugs is five days starting from the second or third day of your menstrual cycle and the ovulation can occur as early as 10 days and as late as three weeks after your first day of menstruation.

2. We have been trying for about 5 months. Apart from the abovementioned medication, are there other ways to boost sperm count?

   Low sperm count can be due to various reasons such as smoking, drinking, intake of some medication; it can also be due to some medical or genetic conditions. You should consult your doctor to find out the cause/s that has been identified for your husband and if it is treatable, he/she will advise you accordingly. However, quitting smoking and drinking, having a healthy diet and lifestyle are a good start to optimising fertility.

3. I track my ovulation religiously and all the Clearblue ovulation test kits do show days leading up to ovulation as well as the actual day of ovulation every month since May this year. As I am terrified of needles and I do get sleepless nights before jabs, could it have caused the blood test results to be askew?

If ovulation test kits are consistently positive, it indicates that you are ovulating on the particular months that you have done them. It is always a good practice to record the day according to the menstrual cycle as it can be used as a guide for future cycles. However, women do not always ovulate every month so the blood test that you have done showing no ovulation could have either been done too early or too late, or you might not have ovulated in that particular month.

4. Are OPKs really "useless", as mentioned by my gynae?

Ovulation prediction kits might not be useful for everyone but they do help some women. However, the best way to time sexual intercourse is not to time them at all but instead, to have regular sexual intercourse twice or thrice a week to avoid adding unnecessary stress.

Question by Gracesmum

Hi Dr. Before I had my daughter who is now coming to 3 yrs old, my husband and I had been trying to conceive for about 4 yrs. Now we are thinking to have another baby but I worry history will repeat itself. I hear that it will be easier to conceive again after the 1st pregnancy. Is this true, even for someone who struggled with infertility the 1st time round? If true, any explanation behind it?

Answered by Dr Veronique Viardot-Foucault:

The success rate of fertility therapy depends greatly on the age of the woman and the severity of the existing fertility issue(s). It is not possible to predict whether it is going to be easier or more difficult to conceive your second baby because your fertility can change. Some women can conceive naturally and then experience secondary infertility while some women need fertility treatment for the first child but can conceive naturally subsequently.

Most importantly, if you are experiencing difficulties to conceive your second child after attempting for one year, seek an assessment with a fertility specialist.

Question by Arianaa

I am a 35 year old woman who has had rheumatoid arthritis since my teens. I stopped my methotrexate (MTX) medication about 3 years ago to try for a baby, but have not been successful. I have been on low dose steroids (5-7.5 mg daily) and hydrochloroquine to keep my condition in check. I have a few questions which I hope you can help me with:

1. Do chronic conditions like mine have any effect on fertility?
2. Do steroids have any effect on fertility?
3. I just started on Clomid and timing of ovulation method to try to conceive. How long should I try this method before moving on to the next i.e. IUI and so on?
4. Should I manage to conceive, is there any risk of complication arising from my condition that you know of?

Thank you for your time.

Answered by Dr Veronique Viardot-Foucault:

1. Do chronic conditions like mine have any effect on fertility?

Evidence does not suggest that rheumatoid arthritis affects the ability of a woman to conceive. However some treatment of rheumatoid arthritis such as methotrexate (MTX) is contra-indicated during pregnancy. And that is the reason why you were asked to stop it prior to conceiving.

2. Do steroids have any effect on fertility?

Steroids, especially in high doses could affect your ability to conceive and therefore you need to seek your specialist’s advice with regards to the minimal dose required in your case.

3. I just started on Clomid and timing of ovulation method to try to conceive. How long should I try this method before moving on to the next i.e. IUI and so on?

Once the efficacy of Clomid treatment is confirmed (ovulation) at a dose that can be titrated from 50mg to 150mg, we usually recommend four to six cycles of Clomid. Subsequently, if you are not pregnant, you will be advised to consider other alternatives such as intrauterine insemination.

If you are not ovulating with a maximum dose of Clomid (usually 150mg), you would be advised to consider the next line of treatment earlier.

4. Should I manage to conceive, is there any risk of complication arising from my condition that you know of?

I would advise you to seek the advice of your specialist on this question as he/she would be able to explain to you, in details, the potential risks and complications. In addition, if you conceive, you would be taken care of by a specialist familiar with your condition and who can manage your pregnancy at the same time.

Question by jeannie0102

dear dr veronique we had twins successfully via ivf 5 yrs back. is the chance of having twins again via normal pregnancy high? my husband’s side of the family do not have twins. mine also do not have history of twins. thks

Answered by Dr Veronique Viardot-Foucault:

The risk factors of having a multiple pregnancy include the following:

1. Having a family history of multiple pregnancy
2. Delay childbearing until after 30 years old
3. Having one or more previous pregnancies especially a multiple pregnancy
4. Undergoing assisted reproductive techniques

Question by Kopibuck

Im 39 year old and had 2 miscarriages from IVF and a history of fibroids.i had part of my fibroids removed about 3 months ago and due for another surgery to remaining fibroids in a month's time. im recently diagnosed with sticky blood condition and a MTHFR gene mutation. May I know what should I note for subsequent IVF?

Answered by Dr Veronique Viardot-Foucault:

Older age, fibroids indenting the endometrial cavity and methylene tetrahydrofolate reductase (MTHFR) gene mutation are potential risk factors for miscarriages.

Regarding your fibroids, it is usually recommended to wait three to six months after a surgery (myomectomy) to allow your uterine muscle (myometrium) to heal properly before conceiving.

Regarding the MTHFR gene mutation, you should liaise with your specialist to arrange for a genetic counselling and discuss about folic acid supplementation recommendations.

Question by linnx

Dear doctor,

I was on birth control for about 2 years. I started out with oral contraceptives (Diana) for a short while but found it a bit troublesome to take as I would forget to take it sometimes, so I switched to the 3-monthly injections (Depo provera). I have stopped all birth control for 2 years plus now to try for a baby, with no success. I am in my early 30's.

In my early 20's I did also take Diana for a while (less than a year) to regulate my menses during a time where I was facing some stress, but for the most part my period has been quite regular.

I am wondering if the contraceptives have anything to do with this difficulty I am experiencing now in getting pregnant. Thanks in advance.

Answered by Dr Veronique Viardot-Foucault:

After discontinuing oral contraceptives, your menstrual cycle might be irregular for a few months. This can often be explained by a delay in the restoration of your normal ovulation. However if the disturbances persist or if you have not been able to conceive for the past two years despite having fairly regular menstruation cycles, I would recommend that you and your husband seek the help of a fertility specialist to pinpoint the underlying reason for this fertility issue.

About Adj Asst Prof Veronique Viardot-Foucault, celine

Adj Asst Prof. Veronique Viardot-Foucault is a Senior Consultant in the Department of Reproductive medicine, Division of Obstetrics and Gynaecology. 

Dr. Veronique Viardot-Foucault is a Reproductive Endocrinologist. She received her Medical Degree, her specialist accreditation in Endocrinology and Metabolism and sub-specialist accreditation in Reproductive Medicine, from the Medical school of Pierre and Marie Curie University in Paris (France). She has also been awarded a Master of Science in Reproductive Physiology in 2001 in the same university. Upon completing her residency in 2003, she was appointed as an Associate Consultant in the Department of Gynaecology of Hotel-Dieu Hospital of Paris, France for two years. In 2008, she joined the Department of Reproductive Medicine and KKIVF Centre at KK Women’s and Children’s Hospital, Singapore, where she currently holds a position as a Consultant.

Dr. Veronique Viardot-Foucault’s clinical interests are in subfertility management, polycystic ovary syndrome (PCOS), adolescent gynaecology and endocrinology. Her main research interests are in assisted reproductive techniques’ scheduling and outcomes optimisation, poor ovarian responders and polycystic ovary syndrome