A thorough interview of both partners, a detailed pelvic assessment of the female and a basic semen analysis will enable a fertility specialist to establish the diagnosis of the causes for infertility in most cases. Sometimes, additional blood tests or scans may be required to aid in the diagnostic process, for the more challenging cases. In Singapore, the reference ranges used for semen analysis are that of WHO.

The Combine Oral Contraceptive (COC) pills are  supposed to be effective in preventing pregnancy when used properly and fertility should return quickly after cessation of use. However, we do see some women experiencing a delay in return of fertility after using COCs. It is likely that the COCs might have been masking the symptoms of underlying conditions that impair fertility, rather than the COCs causing the impairment of fertility directly. Conditions such as endometriosis and PCOS are easily concealed by COCs as menstrual cycles tend to be regular and less painful, therefore the unsuspecting women do not notice their presence, until they stop using COCs. 

Yes, the age of a woman will have significant impact on her fertility. This starts to be more evident after the age of 37-38 years, in general.

As the age of our first-time mothers increase, we see an increase in prevalence of infertility in our population. Biologically speaking, the reproductive window of a female is a lot smaller than that of a male, often dipping into the worrying (sub-fertile) range after the age of 37-38 years old in general. Of course, this can vary very widely between different women. There are many reasons for infertility itself and hence the treatment, each targeting different conditions, will be varied. It is important to accurately diagnose the medical conditions present and tackle each one accordingly. For that, you will need the help of a fertility specialist.

The "blind" screening for fertility for mass population usually will include basic hormonal assessment, semen analysis, tubal patency test, egg reserve and ovulation status, ultrasound of the pelvic organs, etc. However, I prefer to tailor the tests to suit the individual woman / couple based on the findings of the pelvic examination; this will avoid unnecessary tests and target the most likely problematic area(s) of that particular couple. Every woman / couple is different. Of course, the eventual treatment will depend on what conditions get picked up on this screening exercise and the expertise of the specialist to deal with them.

If your ear pain is persistent despite ear drops and pain killers, please see a ear specialist or ENT specialist.  The infective material trapped within the ear canal may need to be removed to speed up the recovery.  There may be other causes of ear pain too.  Meanwhile, please keep the ear dry, no swimming and don't cleaning of the ear with cotton bud. 

Hello! In general, after an ankle ORIF surgery the implants used nowadays are quite stable. So putting some transient weight on the injured ankle should not lead to issues. You can get a check X-ray done at your next appointment just to make sure all is going well, though chances should be slim that you would have done any damage to the ORIF surgery. Hope that helps!

Different skin cancers present differently.  Some like melanoma may have ulcer and bleed on its own, even without scratching.  Basal cell carcinoma are usually smooth and pearly in appearance, usually do not bleed.

It is hard to determine without the benefit of seeing a picture of the red mark.  If in doubt, it is advisable to get your local GP to take a look. 

Typically, I quote patients 4-6 months. This of course depends a lot too on how compliant the patient is with physical therapy, the nature of the tear and how well it was reconstructed

Bunions can be corrected without surgery - using splints and spacer devises. Bunions are typically treated surgically once the deformity is quite significant and the patient is symptomatic