Thailand is ageing rapidly. Birth rates have also dropped quite significantly, from 6 children per woman in 1960 to 1.5 in 2015. In addition to this, as many as 1 in 6 couples worldwide have trouble conceiving; a trend that is also mirrored in the Land of Smiles. While infertility is becoming a bigger issue here in Thailand, there are options available to couples looking to increase their chances of conceiving by detecting and treating any infertility issues early. 

To that end, today I'll be sharing some information on the most common fertility issues in Thailand, as well as whether health insurance covers costs related to infertility investigation and treatment. 

4 most common fertility issues in Thailand

There's no one single reason as to why people need fertility treatment. It can be caused by many different reasons, the most common of which include: 

1. Endometriosis

Endometriosis is a health condition in which the tissue that forms in the lining of the woman's uterus grows outside of their uterine cavity. Hormonal fluctuations during a woman's menstrual cycle affect the misplaced tissue, causing it to grow, thicken, and break down. 

Over time, the tissue that has broken down will become trapped in the pelvis area, causing irritation, severe pain during menstruation, and fertility issues. 

The symptoms of endometriosis can be quite similar to other conditions like ovarian cysts, so an accurate diagnosis is important. The only definitive way to diagnose endometriosis is by a laparoscopy, which is a surgical procedure that involves inserting a camera into the pelvis to look for signs of endometriosis. Once it's been diagnosed, the tissue can be removed during the laparoscopy. 

2. Polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) affects around 1 in 10 women of childbearing age. The condition is caused by an imbalance of reproductive hormones, which in turn creates issues in the ovaries. More specifically, this hormonal imbalance means that the egg may not be released or developed as it should during ovulation, thus causing missed/irregular menstrual periods. Irregular menstruation can lead to infertility, as well as the development of cysts. 

There's no single test to diagnose PCOS. Typically, diagnosis of the condition will involve your doctor checking your medical history, conducting a physical exam, and administering tests (e.g. pelvic ultrasound). 

PCOS is one of the most common, but also most treatable, causes of infertility issues in women. Medications are available to treat PCOS, and there are also a range of options that can help increase your chances of conceiving if you have the condition, such as IVF if medication does not work.  

3. Uterine fibroids

A condition that affects 20 to 40 percent of women at least once in their lifetime, fibroids are muscular tumors that usually develop within the walls of the uterus, or sometimes outside the uterine wall, or even in the uterine cavity. 

Most fibroids don't cause any symptoms, but some women can experience frequent urination, lower back pain, pain during sexual intercourse, heavy bleeding, or enlargement of the lower abdomen. Depending on where they're located, uterine fibroids can also block the Fallopian tubes, making successful implantation unlikely or impossible. 

Diagnosis of fibroids typically involves imaging tests (e.g. ultrasound) to confirm whether or not you have fibroids. Sometimes, surgery (e.g. laparoscopy) will be required to know for sure if you have the condition. 

Those who have fibroids and are trying to conceive should discuss with their healthcare provider whether the fibroids are located in places that might prevent them from doing so, or in places that might affect/interfere with the pregnancy. If so, surgical and non-surgical treatment options are available. 

4. Low sperm count and poor sperm quality 

When couples are encountering difficulties conceiving, unfortunately our society is such that the woman is typically assumed to be the only one with infertility problems. However, male infertility contributes to about 30 percent of all infertility cases, and male infertility alone accounts for around 1 in 5 of all cases. 

The vast majority of male infertility cases are caused by poor sperm quality and low sperm count, which are are both diagnosed via semen analysis. As there are a whole host of underlying reasons (e.g. medical conditions, lifestyle factors) behind why men have low sperm count and poor sperm quality, treatment will depend on the cause of their infertility issue. Should no underlying cause be found, couples may resort to Assisted Reproductive Treatments (ART) to increase their chances of getting pregnant. 

Does my health insurance cover infertility investigation and treatment?

Infertility tests and treatments can be expensive in Thailand, so it's a good idea to double check whether your health insurance plan covers this type of care. Typically speaking, only the more comprehensive international health insurance plans will offer coverage for infertility investigation. 

Another thing to be aware of is that infertility can be quite a complex issue when it comes to insurance. It can be hard to prove whether infertility is a pre-existing condition or not, potentially leaving the policyholder feeling frustrated if their insurance provider deems it as such. 

As for fertility treatments like IVF, plans that cover this type of care will usually impose a number of restrictions on this particular benefit, such as long waiting periods, or the requirement that you also obtain maternity insurance. 

If you have any questions about health insurance and infertility coverage in the Land of Smiles, feel free to get in touch with my team at Pacific Prime Thailand today.