6 Lessons You Can Learn From COVID-19

by Dr Agilan Arjunan , Fertility Specialist&Gynaecologist, KL Fertility Centre (Malaysia) 

I was listening to The Mindset Mentor by Rob Dial about lessons learned fromVOVID-19.

Take home message:COVID-19 pandemic not only exposes holes in our government/health system , but also holes within ourselves.” 

These are the points :

  1. Everything happens for a reason. You don’t need to know the reason, just be “OK” with what’s happening and knowing that you are doing your best in this world.
  2. In long term, more good things will come out of these . For example, the waters in the canals in Venice , Italy is more clear now and air quality improves. This is due to restriction of movement order. So maybe more good things will happen because we start looking at doing things differently now.
  3. Are you worrying too much ? Worry comes from being out of control of something. If you worry too much, it only means that you have a control problem. Something perhaps you need to look into this further. You worry too much of things which are out of your control .
  4. Focus on what you CAN control within your small circle of influence. You can control what happens to you and around you.
  5. You learn to choose between LOVE and FEAR during COVID-19 pandemic. Ask yourself , “When you go to a grocery store, do you let an elderly person get their items first of you grab it first out of fear ? ” . If you choose or take the item to yourself, it’s out of fear that you may go hungry.
  6. This COVID-19 pandemic shall pass. The question is how are we going to use this to change ourselves for a better future.

Image : Creator: File  Credit: via REUTERS

1 Minute with Dr.A : COVID-19 and Pregnancy

by Dr. Agilan Arjunan, Fertility Specialist & Gynaecologist ,KL Fertility Centre ( Malaysia) 

Top 3 questions my patients ask me regarding COVID-19 and Pregnancy :

Watch my IGTV video here : https://www.instagram.com/tv/B-FOS3Ej8CY/?utm_source=ig_web_copy_link

  1. Are pregnant women more at risk of getting COVID-19 infection ?
  • At the moment , pregnant women does not appear to be at higher risk of getting COVID-19 compared to the general population.
  • Pregnant women do undergo changes in their bodies which makes them more susceptible to other infections
  • Majority of pregnant women may show only mild to moderate flu like symptoms


2. Can COVID-19 cause any problem during pregnancy ?

  • Currently we do not know if COVID-19 infection causes any problem during pregnancy or to be baby after delivery.
  • Currently there is no evidence of intrauterine infection from COVID-19
  • It is assumed that probably there is no affect on intrauterine fetal growth


3. Can COVID-19 be transmitted from mother to baby ?

  • We do not know if COVID-19 can be transmitted from mother to baby. 


Sources :

  1. https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html
  2. https://www.rcog.org.uk/globalassets/documents/guidelines/2020-03-21-covid19-pregnancy-guidance-2118.pdf




IVF Without Injection

by Dr Agilan Arjunan , Fertility Specialist & Gynaecologist, KL Fertility Centre ( Malaysia)

Main take home point of this article : 

As a fertility doctor, I suggest a young couple who needs an IVF to discuss about IVF protocol without or with very minimal injections. In my practice , I see a good success rate if the couples are selected properly. 

IVF is associated with daily injections of hormones. These hormones are needed to stimulate grow of multiple follicles ( eggs) and to create more than one embryo per IVF cycle.

This approach is commonplace because cumulative pregnancy rate is higher when up to 10-14 eggs are collected per IVF cycle.  While a standard IVF protocol may be good to achieve a higher pregnancy rate, it also has its own disadvantages.

A standard IVF protocol carries a risk of ovarian hyperstimulation (OHSS) , longer days off work , especially after egg collection procedure and a higher total IVF cost .

Probably it’s time to look at a more gentle , perhaps an IVF without or with very minimal injections.

A recent analysis from Japan have looked into the success rate of an IVF protocol with Clomifene Citrate. For a young couple  ( female partner less than 34 yrs old) , the cumulative pregnancy rate after three IVF cycles is about 70% .

In an IVF protocol with oral tablets, the women makes only a few eggs per stimulation . Hence, she may need to repeat the IVF cycle to make more embryos. In a younger couple, generally few eggs are enough to make a good quality embryo. Furthermore , it is much more patient friendly.

On the aspect of cost,  the cost of an IVF cycle can reduce significantly and thus a couple be able to do more than one stimulation cycle .

In my practice, I normally suggest a minimal stimulation IVF for a young couple, provided they fulfil the selection criteria. I see a very good success rate with this approach while reducing the overall IVF cost.

In conclusion, younger couples who need an IVF should discuss about minimal stimulation IVF with their doctor.

Source : https://link.springer.com/article/10.1007/s10815-019-01662-z?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10815_37_2

Happy Women’s Day 2020

I would like to wish a Happy Women’s Day to all women out there who have tirelessly managed to balance her work and family building. You are the real hero !

Happy Chinese New Year

Wishing everyone a Happy and wonderful Chinese New Year. May this year brings happiness and above all a smile to all couples who are trying to conceive .

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