00:00It's basically we need to follow the cycle, right?
00:02So we need to follow the cycle, you have your period.
00:05So that's the early cycle of the period.
00:06Then it will be different from the mid cycle.
00:08So people go like, why are you scanning me over and over?
00:11Because different cycles at different phases is different.
00:15Normally, what is the first step?
00:16Since we know when the couple should seek for help, right?
00:20If they are having regular cycles for a year,
00:23I mean, they don't have any other issues and they don't conceive.
00:26So this is actually a red flag sign that you should actually start seeking medical attention.
00:32So maybe Dr. Natasha, you can share some of your journey also from personal point of view,
00:37from medical point of view.
00:38The first step for the couples who want to start the fertility treatment,
00:43I mean, what are the things that they would be going through?
00:46And how long does it take from the first time that they appear at your clinic
00:50and then doing all the tests and also whatever procedures which is necessary
00:54and before the initiation of the treatment itself?
00:58Okay, I suppose it varies from where you are, where you are for your journey
01:03and which facility, medical facilities you are, you know, seeking treatment.
01:08Because obviously when you are in a government setting,
01:11it will be different from the private setting.
01:14In a private setting, it will be different from whether you are seeing a general practitioner,
01:18a gynecologist or you're seeing a fertility specialist.
01:20For us, for fertility specialist, time is important.
01:23We do not like to delay.
01:25We would like to complete all testing within the next one to two months.
01:28So basic testing needs to be a blood test, which will check blood group,
01:32make sure there are no sexually transmitted disease,
01:35there are no thalassemia, check your rubella status,
01:38check your vitamin D level, which is important for egg quality implantation.
01:43We then check your hormones, make sure there's no imbalance.
01:45Also, then that's blood test for both men and female, husband and wife.
01:52Then we'd also check for the tubes, right, whether it's blood or not.
01:55So there are several ways in checking for the tubes.
01:58And the most important, but not, you know, which we should not forget, is the sperm.
02:04Right.
02:04So from the male side, it's actually quite easy because you need just a blood test and a sperm test done within one setting.
02:11Right.
02:12But for the female, it's basically we need to follow the cycle.
02:16Right.
02:16So we need to follow the cycle.
02:18You have your period.
02:19So that's the early cycle of the period.
02:20Then it will be different from the mid cycle.
02:22So people go like, why are you scanning me over and over?
02:25Because different cycles at different phases is different.
02:29Where you are on your second day of your period is different from where,
02:32what the uterus and the ovaries will look like at your mid cycle.
02:36And from cycle to cycle, from this month, January, February, March, it's different.
02:40Right.
02:41So we actually monitoring and getting to know and see what you do on a normal basis.
02:47so we can anticipate how we're going to move forward.
02:51Okay.
02:51Right.
02:52So we see lots of things.
02:54Sometimes they, you know, would show, okay, this is a scan done by my guy.
02:59I mean, it's not like a chest x-ray.
03:01So I will need to scan myself.
03:03I mean, I'm happy to see like chest x-rays and things.
03:06But for ultrasound, it's better to be doing the ultrasound myself.
03:10It depends on when I'm doing it, which cycle.
03:13Right.
03:13So after that's done, I think that's been in one to two months.
03:16It should be done.
03:17And depending where you want to move forward, depending on the results,
03:21you are ready to move towards treatment, which is suitable.
03:24And it depends on how fast the couples want to move or where they are.
03:29Like, you know, younger couples, we can wait.
03:31But sometimes younger couples don't want to wait anyway.
03:33So actually, I will have to then depend on the patients, what they want to do.
03:37Okay.
03:38And some couples would want to do things faster.
03:41Like they go like, what, IUI 10, 15%, forget about it.
03:44Okay.
03:44I want IVF, I've got, you know, the means, the social means.
03:47I've got the money.
03:48I want to move fast.
03:49So we actually do then recommend accordingly.
03:53All right.
03:53Yeah.
03:53So things to anticipate for gynae, we do do scans.
03:58And majority of the time, we do vaginal scan.
04:00Okay.
04:00Right.
04:00Then you can only see accurately and clearly the ovaries.
04:05So be prepared that we do a vagina scan.
04:08Also be ready.
04:17Woo hoo!
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04:27All right.
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