What awaits the traveller?

What awaits the traveller?

 

 

Malaysia’s role in health tourism: What can the patient expect?

 

 

Andrew Coutts takes a look at what awaits the healthcare traveller in Malaysia.

 

The Malaysian Government identified the growth potential of medical tourism in the late 1990’s and took the strategic decision to pool the collective strengths of the private and public sectors to harness the country’s medical tourism industry. It was a decision which proved to be extremely productive.

 The unique private/public collaboration which saw health tourism promoted by the Government and fuelled by the corporate sector provided tourists with the stamp of regulatory approval in terms of quality, safety standards and medical related legislation. This endorsement combined with significant investment powered the development of the sector until it was so rudely disrupted in early 2020 by the Coronavirus pandemic. Up until March 2020 health tourism in Malaysia had seen monumental year on year increases in terms of both the numbers of patients travelling for medical treatment and income generated by the activity. Between 2011 and 2018 the number of healthcare travellers’ who visited Malaysia more than doubled from 643,000 to nearly 1.3 million.

Central to the exponential growth of medical tourism has been the considerable influence and work of the Malaysia Healthcare Travel Council (MHTC), the Malaysian government’s medical tourism arm. MHTC grasped the notion early on that branding is the key to effective marketing and with this in mind, it has developed a unique brand which has become synonymous with a portfolio of services designed to promote and support the ‘whole’ patient experience. Recognising that the medical procedure only forms part of this experience MHTC facilitates the overall patient journey in aspects of accessing information, the most appropriate treatment options for the patient, whilst collaborating with the country’s hotel, travel and leisure sectors to create a memorable truly Malaysian experience. A package of care which has ticked a number of boxes: facilitating the most appropriate treatment options for the patient whilst stimulating the country’s hotel, travel and leisure sectors.

MHTC’s work has also benefitted from the resources it has had at its disposal. The country is blessed with a wealth of available and skilled medical and technical expertise, political and economic stability, excellent infrastructure and transport links and a tourism sector with an exceptional track record in attracting visitors in their millions from all over the world.

 

 

What Can Patient’s Expect?

 

 The country offers healthcare, accommodation, entertainment and travel at very competitive prices. Tourist resorts sit in a tropical climate, ideal for rest and recuperation and there is no need for visitors to obtain a visa for stays less than 90 days in general. The vast majority of care providers speak English and there are no waiting lists for whichever medical treatment you require.

Many of the country’s 200 private hospitals provide excellent rehabilitation and wellness facilities to ensure travellers can access help and support for recovery purposes and each is recognised by internationally accredited bodies including the Joint Commission International (JCI) and the International Society for Quality in Health Care (ISQua) reflecting their commitment to high-quality care.

 This commitment to upholding the highest standards of care and service has consistently attracted external recognition in the form of both travel and healthcare awards. The country has been awarded the “Best Healthcare In The World” category in the International Living Annual Global Retirement Index in four out of the previous five years. At the most recent ‘International Medical Travel Journal Awards’ the country’s total belief in patient-centred philosophy was acknowledged by the awarding of 9 out of the total of 15 honours announced; a feat not matched by any other country in the world.

 

 

 

The Future of Health Tourism in Malaysia

 

 MHTC recently staged the fifth annual, ‘insigHT’, the region’s medical travel market intelligence conference. This virtual event staged during the Coronavirus pandemic brought together leaders from worldwide medical tourism hubs to discuss the future of the sector.

 As borders begin to open and patients prepare to travel once more in 2021 flexibility, innovation and collaboration were identified as the key drivers for renewal and growth. Malaysia hopes that the blueprint for private and public sector collaboration it initiated in the late 1990’s to promote good health will now enable it to achieve a far quicker recovery than in countries less prepared. The conference acknowledged that the pandemic has also accelerated the need for healthcare to embrace Innovation and digitalisation and harness available technology to assist communication between patient and provider.

The future may not be as certain as it was at the beginning of 2020 but you can be assured that Malaysia with a track record stretching over twenty years is very well placed to harness existing technology and ensure that patients remain at the very centre of the medical and tourism service it provides. 

The Covid-19 pandemic in Malaysia and its response

The Covid-19 pandemic in Malaysia and its response

The Covid-19 pandemic in Malaysia and its response

 

In a first of a series of articles on Malaysia and its role in world health tourism, Andrew Coutts looks at Malaysia’s response to the Coronavirus Pandemic.

Malaysia’s response to the outbreak of the Coronavirus disease was swift and effective. Coherent and collective action from individuals, policy makers and practitioners very early into the pandemic proved to be a key factor in the country, with its population of 31 million people, limiting both cases and deaths whilst supporting and then promoting individuals and the economy at large.

The country acted quickly following the first COVID-19 case outside China which was reported in Thailand on 13 January 2020, establishing an effective screening process at all airports. This was followed shortly after by an initial financial stimulus package over nearly £4 billion and a subsequent £46 billion ‘PRIHATIN’ package to aid micro, small, and medium-sized enterprises for employee retention.

Financial packages were further supported by federal measures such as the Movement Control Order enforced in March 2020, and widely adopted media campaigns promoting the hashtag #stayhome, did much to reduce both the unessential movement of peoples and infections. Cross sector collaboration was exemplified by large numbers of Non-Governmental Organizations assisting in the production of personal protective equipment as well as support from both conventional and Islamic insurance sectors who established a multi-million pound fund to assist with COVID-19 testing.

In the early days of the pandemic most companies had their employees working from home; Non-Governmental Organisations took on the immense role of helping to provide food and shelter for the homeless and all educational institutions, schools, and higher education institutions closed their doors to face to face teaching.

The country reported its first COVID-19-positive case on 25 January 2020 and by mid-April the figure had risen to almost 4,500 with 70 deaths; significant numbers but substantially lower than other countries that were following a similar timeline trajectory. These included the U.S. which had recorded 502,876 cases with 80,747 deaths and the U.K. with 73,758 recorded cases and 8,958 deaths.

In part the successful management of the pandemic at its early stage was due to the way that the Malaysian Prime Minister’s Department (Economy), Health Ministry, Finance Ministry and the National Security Council were able to adapt to a very fluid situation. Health screening at all points of entry into the country and the Movement Control Order were enlisted rapidly but so too was the establishment of cross sector collaborations aimed at supporting the growing health needs through financial and logistical assistance.

The Malaysia Health Coalition, established by the collaboration of 38 medical societies was a perfect example of this which supported the effort of the Ministry of Health to ensure the transparent flow of accurate health information.

A dedicated COVID-19 Fund was also launched to assist patients who had been directly affected by quarantine procedures and those without an income received a daily subsistence sum whilst either being treated or in quarantine.

The Ministry of Health also converted the country’s largest convention centre into a 604 bed field hospital and made provision for conversion of indoor stadiums and public halls should they be required; there was also a commitment from 3,000 retired nurses who were prepared to return to work voluntarily.

As a result of early federal intervention; the mobilisation of private and public sectors and most importantly a population who were prepared to follow the rules regarding essential regulations such as the wearing of face coverings and social distancing, Malaysia fought and continues to fight COVID-19 as effectively as an other nation in the world.

At the time of writing, the country was ranked 64th in the world based on the number of positive cases of COVID-19.

As we all look to the future with renewed optimism that a number of vaccines may be effective to stimulate immunity from COVID-19, policy makers and practitioners are moving from a position of maintenance and defence to growth and redevelopment. The redevelopment is perhaps nowhere more apparent than in the field of healthcare tourism.

The recent Governmental change in Malaysia has established an Economic Action Council to target economic regrowth. The Ministry of Health has benefitted to the tune of £110 million from the fund and almost £6.5 million has been set aside for work undertaken by the Malaysia Healthcare Tourism Council (MHTC), an increase of 40%.

The confidence placed in the work of MHTC by the Malaysian Government is both testimony to the work undertaken by the Council to date which has seen the country become one of the leading destinations for medical tourism in the world and its perceived ability to act as a catalyst for economic growth as the world reopens for business. A point not lost on MHTC’s chief executive officer, Sherene Azli who said following the recent fund announcement,

“The increase in federal support will further optimise the healthcare travel industry for economic revitalisation and has the ability to contribute up to RM10 billion (£1.9 billion) to the economy as the industry recovers.”

Over the coming months we will examine how Malaysia has taken the niche mantle of health tourism, developed it, and enabled it to become one of the country’s major assets. An asset which has been on pause for much of 2020 but will surely emerge just as strong in 2021.

Assisted fertility can be stressful and disarming

Assisted fertility can be stressful and disarming

 

Assisted fertility can be stressful and disarming. Since day one, we have strived to elevate the patient experience by creating a humanizing and caring environment”

Dr. Marjorie Dixon, CEO and Medical Director of Anova Fertility & Reproductive Health

It is easy and understandable to dwell on some of the tough realities of the moment, but we want to share some positivity during the UK’s annual Fertility Week, organised by Fertility Network UK. We did not need to look any further than the inspirational Dr. Marjorie Dixon, the founder of IFC’s Canadian partner Anova Fertility & Reproductive Health, to provide a breath of fresh air.

Q. Anova has grown into one of Canada’s leading next generation clinics in four short years; what motivated you to start it?

I returned to Canada after a certified fellowship in the U.S. and became disillusioned with what I saw to be the care options available to Canadians. When I asked why we were doing things a certain way, I was told that change was just about impossible. This is the worst kind of response I could have been given as it merely inspired me to go after change. There’s nothing worse for a Type A, analytically-driven, scientific person to be told “this is the way it is’. I built a team of inspirational achievers who shared my goal and we went for it.

On one side, from a more technical perspective, I knew that we could do better by building a centre that invested in the latest science and technology. I am so proud of our lab and people, we have a state of the art facility and it is the magic behind the success rates that we have at Anova.

From another perspective, I wanted to address that fertility clinics are often primarily geared towards heterosexual couples who are struggling with infertility. As an LGBTQ+ community member myself, and the mother of three IVF children, I recognized that there is a gap in access to care but also information since I experienced it personally. I made it part of Anova’s mission to make the path to parenthood as clear and supportive as possible for everyone, as love is love and everyone has the right to a family.

Q. So what is your goal?

Our goal is to improve the experience of reproduction — to improve the journey regardless of family status and sexual identity. To make family accessible to everyone, because we have the ability and training to do so. It’s in our mission statement: To provide individual care for patients of every age and situation.

I acknowledge that assisted fertility is stressful and disarming. I had IVF and I remember every single treatment. So we design the rooms differently. We host support groups because there is power in social interactions with others going through the same thing. I believe that the experience of fertility care is just as important as the science.

Q. It is personal then?

Of course, my experience as a patient shaped my thinking. As a black, female, LGBTQI+ I am familiar with what it means to be marginalized. I also know first-hand how stressful the fertility journey can be so wanted above all to offer patient-focused fertility care under one roof. The journey of fertility can be disarming on the best of days, and alienating, so we were determined to offer wrap around care in one physical location, undertaken by a compassionate and empathetic team.

The fertility journey is the ultimate equalizer. If you take a look around our clinic, we have every type of person coming through our doors, and they sit together with one goal in common: a legacy of their own, a family of their own.

This desire is wholeheartedly supported and shared by Anova’s entire team.

 

Q: What’s next for you, and for Anova Fertility?

We have had success, growth, and provided improved access to care. But there is still so much to do. I don’t think it ends. I believe we need to find champions to create a movement of improved access to every member of the community regardless of gender or sexual orientation. I envision a clinic that focuses on reproductive health, family planning and sexual wellbeing. This includes education and involving our patients in the decisions about their care in each stage of their journey. Every person is unique, and so should be their fertility plan.

Hopefully, the legacy we leave through Anova Fertility is one of sustainable change in medicine. I am so blessed to do what I do every single day. It is immensely rewarding to make babies, with lots of love and a some science.

 

Link:

https://markets.businessinsider.com/news/stocks/anova-fertility-reproductive-health-primed-for-growth-following-partnership-with-persistence-capital-partners-1028314880

 

Are we beginning to feel the strain of too many webinars?

Are we beginning to feel the strain of too many webinars?

Are we beginning to feel the strain of too many webinars?

Andrew Coutts

 

Pre Covid-19 there were only a few opportunities to jump online onto a presentation or discussion about fertility. Some of the forward thinking and marketing driven treatment providers were ahead of the game and were already sharing webinars featuring patient testimonials, clinic walk throughs and expert talks before the first Coronavirus infection. A few of the more active Insta Influencers had spotted the potential of the online ‘Live’ and were using it to share education, offer advice or to merely promote themselves. For most of the time, it worked.

Then in the early spring of 2020 Covid-19 started creeping and within a relatively short period it had lept on societies across the globe, pausing, cancelling and shutting down everything in its way. The fertility field was no exception, clinics closed, treatments were cancelled, hopes were put on hold.

Like many other countries the UK went, after polite consideration, into full lockdown in March 2020. There was general consensus that staying away from each other was the right thing to do so as a nation we took our ball and went inside. And, we rolled slowly forward.

Like every other field of activity, the fertility community took a breath, stepped back but then thought, what next?. Our biological clocks didn’t stop for Covid-19 and as each day and month passed the ticking got a little louder. Patients sought assurances, answers. Professionals did their best to comfort but the virus caused uncertainty and this uncertainty which began as a ripple, then raged across the tightly knitted fertility community.

Trying to conceive and failing is one of the most stressful emotions you can experience and historically it was an emotion that wasn’t shared, even among close family and friends. I brushed against the fertility field as a patient twenty years ago and ten years later as a professional. In that time there was a noticeable shift in the way individuals and society viewed infertility. As more of us were becoming affected by it, the more fertility stepped out of the shadows. In short, fertility joined the mainstream.

A new profession was born. ‘Fertility Specialist’ became a title not solely owned by the medical doctor; now it began to be adopted by a new crowd of individuals and agencies offering emotional support, coaching and even fertility travel, my own area of interest. This groundswell of people queing up to share information and advice on every aspect of infertility meant that in many ways the fertility patient too, became a Fertility Specialist. Infertility had arrived and we were at last beginning to talk about it.

Then, bang. Coronavirus reared its ugly head and started to have a real impact on people’s ability to access time limited fertility treatment. Older patients wondered if they were going to be ‘too old’ to get their treatment – Even (good) private clinics now have an upper age limit for patients – others were anxious about their ‘frozen’ embryos stored in laboratories and others speculated whether treatment would actually start again.

 The fertility community was crying out for a ‘cure’ like the rest of society. Their cure however didn’t come in a syringe, it emerged in the form of the Webinar. After weeks of uncertainty the webinar became the school yard for adults interested in fertility, an online haven for ideas, rants, frustrations, tears but also for reassurance, comfort and support.

My inbox and social media platforms bulged daily with invites to Insta Lives, Zooms, and Teams sent from all over the world. Speaking as a ‘Boomer’ I was blown away, telemedicine had suddenly come of age and patients were beginning to benefit from online services that hadn’t existed six months previously. Clinics and clinicians were talking to patients in their own homes; patients were talking to each other in safe, private environments and couples were ordering products designed to offer the promise of parenthood.

Webinars were running headlong towards the sombre spectre of Covid-19 and there was a great sense of togetherness and community. Some great examples of education and support were provided; myivfanswers.com launched over 250 videos and webinars that brought together ‘proper’ fertility specialists from all over the world. Closer to home, ‘The Man cave’ Instagram webinars offered the inspirational and honest thoughts of a male fertility patient.

Six months after the first wave of fertility webinars there appears to be no wane in the number of webinars and videos going live. A recent conversation with a colleague, and the reason behind this article, got me thinking, are we beginning to feel the strain of too many webinars? My eyes glazed when he calmly announced that he had spoken at 42 webinars in the previous three weeks, quite a feat at two a day. I wondered what there was left to say.

As the levels of compliance that were upheld by so many in March begin to fray in the face of lockdown yo yo I wonder if the fertility community too has also become tired of the webinar. I have randomly begun to surf Lives and videos and notice invariably there might be 3 people watching, I imagine the presenters disappointment as three become two as I leave.

And as we huncker down for what is likely to be a long winter it will be interesting to see if the fertility webinar can regain and maintain its popularity or whether like Covid it will slowly take a step back into the shadows.

Whilst we wait, my first webinar, ‘It Doesn’t Stop at the Pot’, a male only discussion on male fertility diagnosis and treatment is going live on Wednesday 4 November, to mark the UK’s Fertility Week. I have decided to play rather than to shout from the touchline. Hopefully we will attract a good crowd.

Andrew Coutts is the Chief Executive of the International Fertility Company and a PhD Research student at the Centre for Reproduction Research at the Du Montfort University.

Does a vegan diet improve fertility?

Does a vegan diet improve fertility?

Does a vegan diet improve fertility?

Stefanie Valakas

(Image Credit: VeganLiftz)

 

One of the most common questions I am asked as a fertility dietitian is whether going vegan can improve fertility.

First, a quick distinction:

  • Vegan diet = diet free of meat, fish, poultry, eggs, dairy, honey and all products of animals
  • Vegetarian diet = diet free of meat, fish and poultry but includes eggs and dairy (also known as lacto-ovo-vegetarian)
  • “Plant-based” diet = a term that has recently emerged that has different definitions depending on who you ask, I see it more similar to “flexitarian” where people follow a dominantly vegetarian style of diet with a plant focus, but still include small portions of meat, fish, poultry on a less frequent basis.

So, is going vegan a good idea if you are trying to enhance your fertility and chances of conceiving? Let’s get into the pros and cons.

Pro: Eating more fruits and vegetables, legumes, nuts & wholegrains

As a dietitian, I am NOT going to be the one to complain about eating more plant foods including:

  • Fruit
  • Vegetables
  • Wholegrains
  • Nuts & seeds
  • Legumes & beans

These all provide essential nutrients for fertility including antioxidants to help fight inflammation, fibre, B vitamins including folate which is key for preventing neural tube defects in early pregnancy and is found in fortified breads and cereals and dark green leafy veggies. Nuts and seeds provide healthy fats and a range of minerals including zinc and selenium. Legumes and beans provide plant-based protein, zinc, magnesium, B vitamins and plant-based iron – critical nutrients for men and women when trying to conceive too! So there are definitely upsides to a vegan diet!

You can read more about why these nutrients are important in the pre-conception period here.

Pro: Vegetable Protein vs Animal Protein

A vegan diet, by nature, is focused more on plant proteins from beans, legumes, tofu, tempeh, nuts and seeds as well as wholegrains and plant-based milks. Many people actually forget that foods such as bread and pasta do offer some protein to the diet too, in fact a single slice of seeded bread can provide up to 4 grams of protein per slice!

Worried about soy and your hormones? Get the facts here.

Research in the fertility nutrition space has shown that even just 5% of the total calories (FYI that’s 25 grams of protein in a standard 2000 calorie or 8700 kJ diet) being from vegetable protein over animal protein, reduced the risk of ovulatory infertility (Chavarro et al., 2011)!

So it looks like it is worth even just borrowing this little nugget of information and incorporating more plant foods for fertility, without necessarily going fully vegan can be a positive first step!

Want my vegan Satay Tofu Soba Noodle recipe? Get the recipe here.

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DOES THE VEGAN DIET IMPROVE FERTILITY? 🌿// Link in my bio to read the blog post where I weigh in on the pros and cons of a vegan diet for fertility ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ 🍉 Whilst a well-planned vegan diet can provide health benefits including consuming more plant foods and vegetable protein associated with reduced risk of infertility, however…. ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⚠️There is a risk of nutrient deficiency without careful planning! ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ 🥤Some also buy into the highly processed vegan products on the market or justifying foods and drinks like soft drinks as they are vegan, giving these products a health halo they probably don't deserve ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ☹️ Unfortunately, I haven't been able to find any specific evidence of a vegan diet intervention for fertility ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ✨Read more on my latest blog post link in my bio⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ #fertilitydiet #fertilitynutrition #ivfdiet #fertilitydiettips #fertilityfood #ivfnutrition #ivfgotthis #womenshealth #vegandiet #vegannutrition #plantbaseddiet #vegandiettips #ttctribe #ttcsisters #ttcaussies #ttcaustralia #periodchat #waitingforaf #ttcaussiesconnect #ttccommunity #infertilitywarrior #infertilitysucks #nutritionplusdietitians #thedietologist #innerwestsydney #newtown #easternsuburbs #bondijunction #sydneyaustralia

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Pro: Plenty of Fibre

One of my favourite parts of a well-planned vegan diet is the abundance of dietary fibre that’s on offer! From fruits, veggies, wholegrains and legumes and beans the opportunity to meet the 25-30 gram per day target becomes much simpler with the abundance of plant foods on offer.

The benefits of getting enough fibre are numerous from feeding the gut microbiome with prebiotics to keep the gut bugs healthy, to keeping you regular which is key for removing any hormone waste products leaving the body – obviously important for optimal fertility.

A high fibre diet has also been shown to be beneficial for endometriosis as it can help lower oestrogen levels in the body which can contribute to endometriosis growing (Gaskins et al., 2009).

Want my fibre-rich vegan rice paper roll recipe? Grab it here.

I hear you thinking, “well sounds pretty good so far, maybe I should be going vegan for my fertility?”, here’s the cons (for balance) for you to consider before taking the plunge:

Con: Nutrient Deficiencies

Just like any other dietary pattern with some level of restriction, there is a risk of nutrient deficiencies. This can be absolutely critical during the lifestage where you are thinking about becoming pregnant and nutrient demands are increasing to support you and your baby throughout pregnancy and breastfeeding.

Here’s a brief run down for the nutrients you need to be mindful on when following a vegan diet:

  • Vitamin B12: naturally found exclusively in animal foods, important for nerve health, and supports folate in its role in building DNA in our cells – critical when wanting to build a new life! Whilst we don’t need much B12, we do need some daily and it can take a while to find out we are deficient. Look for added B12 in soy milks and other products such as nutritional yeast and incorporate these regularly, or consider supplementation. Read more about B12 in prenatal supplements here.
  • Iron: a nutrient that many women struggle to get enough of, during pregnancy a woman’s requirements soar from 18 mg pre-pregnancy to a whopping 27 mg! It is challenging to get by without supplementation during pregnancy, but choosing iron-rich plant foods and combining with sources of vitamin C such as fruit, lemon juice, chilli, broccoli, spinach, tomato or capsicum can help with absorption. Avoiding foods or supplements containing high levels of calcium or zinc and avoiding tea and coffee for 1-2 hours around meals can help too as these can all inhibit the absorption of iron! Get more tips about iron here.

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IRON // An essential nutrient found in the centre of every red blood cell circulating in your veins, in charge of moving oxygen from your lungs to all your tissues (pretty critical stuff) . 🥫 Women need 18 mg of iron each day whilst men only need 8 mg, and this only increases if you're very active, have heavy periods (more losses) or are pregnant! . 🥩 Most women struggle to keep up with their iron needs, but some smart meal planning can help boost it, here are some great animal-based and plant-based sources of iron: . 🥩 Beef 🍣 Salmon 🥫 Tinned tuna 🥫 Kidney beans 🥣 Fortified breakfast cereals like Weetbix or AllBran 🌿 Tofu . 🤔 Remember, the animal-based sources are better absorbed, whilst the plant-based soruces are not but combining with a source of vitamin C (go back a few posts to read about the best sources) can help with absorption! . 🤰 You want to ensure your iron is within range on your bloodwork before trying to conceive to ensure you're not behind the eight-ball when it comes to pregnancy where demands only increase! . 👇 When was the last time you got your iron checked?

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  • Zinc: zinc is critical for the DNA found in the sperm and the egg! Zinc is typically found in meat, fish, seafood, chicken and turkey. However, on a vegan diet, you can get zinc from legumes and beans, nuts & seeds!
  • Iodine: iodine is critical for protecting baby’s developing brain health, found in seafood and also in fortified breads and cereals due to the addition of iodised salt. On a vegan diet, opt for seaweed as a snack or make homemade sushi and ensure you are using iodised salt at home. Check the back of your prenatal supplement to ensure you are getting enough iodine too.

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IODINE // A critical nutrient during pregnancy to help support Mum's thyroid function and support baby's growth and development. . 🤰 As I always say, eat like you're pregnant when trying to conceive so loading up your plate with these iodine rich foods is a good idea when #ttc . 🌿 This nutrient is especially important if you're vegetarian or vegan! . ✔️ Seaweed – rich in iodine kombu has the highest iodine content giving you nearly 2000% of your daily iodine needs (whoah!) followed by wakame (about 44%) then nori (10-30% of your daily needs when TTC) . 🦐 Prawns and seafood are rich in iodine too! Load up on seafood twice a week to help get this nutrient in! . 🥚 Eggs especially the yolk, can be a good source of iodine whilst boosting the protein in your meal! . 🥫 Canned Tuna is a convenient source of iodine perfect for work lunches! Choose brands with smaller fish and with higher omega-3 content! . ✔️ Iodised salt – whilst most of us eat way too much salt. Switching the salt you do use in cooking to Iodised varieties can vs a simple swap, and look at how much salt is coming from processed foods, sauces and canned foods too and choose reduced salt varieties! . 🍞 Bread in Australia is made with Iodised salt and is one the key sources in our diets that protects women with unplanned pregnancies that may not be taking a prenatal supplement. . 👇 What's your favourite source of iodine?

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  • Vitamin D: there has been mixed evidence about vitamin D and its role in fertility, no doubt it is a critical nutrient for our bones and immune health too. Getting enough vitamin D can be challenging for most adults, of course, the best source is the sun, followed by vitamin D fortified mushrooms when following a vegan diet. Get your levels tested and speak to your GP about supplementation if you are deficient.

Need help choosing a vegan prenatal supplement that’s right for you? Book in for a 30 min express prenatal supplement consult.

Con: Don’t buy into the vegan “junk” food

Once you get started on a vegan diet, you may start noticing “oh hang on a second, chips are vegan, this coconut ice-cream is also vegan, and this fizzy drink too!” – you get the picture. Instead of focusing on what we call core food groups, the label of “vegan” gets us all excited and validating any food choice under the sun.

We know that minimising sugary drinks and processed foods is important when trying to conceive (Hatch et al., 2018).

Now, this isn’t to say you can’t enjoy these foods just like anyone else! But just like any dietary label, don’t let it make you blind to the other properties of the food and what they really have to offer for you.

With the rise of plant-based meat alternatives, we need to really keep these processed foods in check as they have been shown to be high in salt and may not be as healthy of an option as they appear on the surface.

Con: No evidence to support vegan style diet specifically for fertility

Unfortunately, at this time, there have not been any specific studies comparing the fertility of those following a healthful vegan diet versus those following Australian dietary guidelines or something similar, so it is hard to know the direct effect of a vegan diet on fertility. Just because the evidence is lacking it doesn’t mean it wouldn’t be of benefit, but it doesn’t give us any guidance.

The Verdict?

Incorporating more plant foods is a great idea when trying to conceive, focus on fruit, vegetables, wholegrains, legumes and beans and nuts & seeds as well as extra virgin olive oil – all these foods are definitely going to benefit you as a couple when trying to conceive.

  • However, if you don’t feel inclined to go cold turkey on meat, poultry, fish, dairy and eggs – that’s okay! These foods have important nutrients to offer for your fertility health too.
  • Don’t forget to monitor your iron and B12 levels as being deficient may interfere with your fertility, ensure you prioritise fortified foods such as plant-based milk with added B12 or nutritional yeast, and combined plant-based sources of iron with vitamin C (e,g. chickpeas and tomato) to help absorption.
  • Be mindful of any kind of restriction when trying to conceive or pregnant, especially if you have a strained relationship with food or a history of one as this can really bring up mental health challenges for some people too.
  • Get help from a dietitian to ensure you’ve got your bases covered.

I support many women trying to conceive and pregnant who choose to follow a vegan style diet for a variety of other reasons and it is definitely do-able with great planning, expert advice and support!

Book yourself in for a FREE 15 min discovery call and let’s talk about planning a well-balanced vegan, vegetarian or plant-based diet to support you before pregnancy.

A New Year, A New Experience

A New Year, A New Experience

A New Year, A New Experience

Andrew Coutts

I began 2020 enthusiastically looking forward to my first trip to Malaysia to view the best healthcare facilities and experts that the country had to offer. Initial conversations with the Malaysia Healthcare Travel Council began after I had witnessed its CEO, Sherene Azli give a show stopping talk about the opportunities available to patients at an International Medical Travel Journal event in Athens in 2018.

 

The talk showcased the prestigious private healthcare institutions who partner MHTC and offer breath taking facilities with jaw dropping medic/patient ratios and cutting edge treatments and technologies. But, what was equally impressive was the way Sherene spoke about the individuals involved, the care givers, the support workers and the medics who were committed to providing the highest standards of care and treatment to ever growing numbers of patients from across the globe.

So too, was the emphasis placed on the care and support offered to health tourists from the moment they arrive in the country with access to dedicated Concierge services and Lounges in the Kuala Lumpur International Airport (KLIA) and Penang International Airport to the moment they leave.

This level of service is not offered merely as ‘front of house’ effect, it continues throughout the patient’s stay in Malaysia where they and their travelling companions can access medical, wellness and tourist facilities.

In my job as an international fertility travel consultant I travel the world reviewing services, facilities and professionals however MHTC and the ‘Malaysian Experience’ offers a layer of comfort that I have rarely seen before.

To put it simply. This is not just medical tourism, this is ‘wrap around’ care and support at its most sophisticated.

Like the majority of events, campaigns and initiatives planned for 2020 the highly anticipated, “Malaysia Year of Healthcare Travel 2020” and linked “Visit Malaysia 2020” campaigns had to be postponed but despite Covid-19’s best efforts Malaysia has been both robust and successful in its handling and containment of the pandemic which has caused world wide devastation and disruption.

At the time of writing (September 2020) Malaysia is reporting a recovery rate of 96.6% for those that have been infected by the disease which puts it near the top of the list of countries who have been most successful with its medical and social distancing interventions. The World Health Organization (WHO) commended the country for being one of the best prepared for the outbreak and its Health Director-General, Tan Sri Dato’ Sri Dr. Noor Hisham Abdullah has been recognised as one of the ‘top three doctors’ in the world by China Global Television Network (CGTN). It is no wonder therefore that Prime Minister Tan Sri Muhyiddin Yassin recently proclaimed,

“Malaysia is recognised as one of the best countries in dealing with COVID-19 and the death rates attributed to COVID-19 are among the lowest in the world”.

Malaysia’s response to the pandemic is another indication of its ability to tackle, supress and succeed in treating disease and illness. It is no surprise therefore that it has become one of the fastest growing destinations for medical travellers who arrive seeking interventions to treat, stabilise or cure.

 

Covid-19 has had an enormous short term effect on the country’s medical tourist trade and normal travel behavour patterns may not return soon but MHTC’s CEO Sherene Azli believes that the country’s experience and track record will enable it to bounce back, and bounce back with some impact over the next five years,

“Malaysia expects to welcome fewer than 300,000 medical tourists this year, compared with nearly 1.3 million last year but we are confident that our ambitious plans for recovery are realistic and sustainable”.

The Malaysia Healthcare Industry Blueprint (2020-2025) outlines strategies to catalyse industry rebound and enable Malaysia Healthcare to attain/achieve pre-COVID-19 performance by 2025.The blueprint aims to increase the revenue generated from healthcare travellers to a minimum of RM4.2 billion (US$1.01 billion) by 2025.

The blueprint is ambitious but the joined up approach to medical tourism with MHTC acting as the lynchpin to a collection of leading health and wellness providers, backed by central Government support will ensure that the country continues to lead in an increasingly competitive field.

By 2022 it is estimated that the global healthcare travel market is estimated to be worth RM82.7 billion.

Health and wellness tourism is ‘big business’ and despite a temporary pause in travel it will return, and return with gusto. Malaysia is prepared and will respond with the efficiency and competency it is known for.

My particular interest is fertility travel which is one of the fastest growing sectors of medical tourism. Falling fertility rates as well as individuals delaying parenthood, environmental factors and the emergence of new diagnostics and interventions have contributed to the rise in treatment providers and clinics encouraging cross border travel.

Results from the 2020 Fertility Travel Survey facilitated by the International Fertility Company highlight the main motivators behind fertility travel. These include cost, perceived success rates, treatments offered and the level of care and support offered by providers. Recognised as one of the most comprehensive fertility travel surveys ever undertaken, 97% of participants said that would continue to travel once the temporary restrictions regarding travel due to the coronavirus pandemic were lifted.

So, how does Malaysia score on the top four motivators behind fertility travel and what might allow it to become recognised as the fertility hub of Asia?

Costs:

Treatments are affordable, with each in-vitro fertilization cycle costing between RM16,500 and RM20,600 (US$4,000 and US$5,000). Uniquely, there is also legislation in place to ensure that international patients are not charged any more than domestic patients for the same treatment.

Success rates:

Statistics from MHTC show that clinical pregnancy is successful in one in two fertility patients in Malaysia.

Support:

The Malaysian healthcare system is universally regarded as well-regulated and patients are offered fertility packages which combine health, wealth and tourism and include medical expenses, accommodation, airport transfers and cycle planning.

Treatments Offered:

Procedures widely available in Malaysia are ovulation induction with timed intercourse (TIC), ovulation with intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), assisted hatching (AH), blastocyst transfer (BT) and embryo and sperm cryopreservation. Other treatments include sperm and egg donation (a service available only to non-Muslims) gamete intra fallopian transfer (GIFT), zygote intra fallopian transfer (ZIFT) and frozen embryo transfers (FET).

Ticking The Right Boxes

Malaysia does seem to tick the right boxes for fertility patients looking to travel and with its Government committed to universal access to high quality healthcare for both the domestic and international patient facilities are on par with anything you might find in Europe or North America.

The country is using the universal pause on medical tourism to provide flexible alternatives to face to face consultations. These include online telemedicine support, maintaining communication between doctor and patient and preparing travellers to ensure they are ready to visit Malaysia when travel restrictions are lifted.

What I like about the Malaysian approach to fertility treatment

The current population of Malaysia is just over 32 million according to the latest United Nations data. It is relatively intimate country which provides a very warm welcome to visitors from all over the globe. Famed for its natural, cultural, historical and gastronomic attractions, its understanding and tolerance of religious and cultural differences it is cosmopolitan and transnational in every sense.

It has the infrastructure which is properly financed and supported to promote medical tourism and the blend of private and public participation ensures that all have bought in and are committed to the aim of making the country a medical destination of choice.

As a fertility practitioner advising patients about travel Malaysia makes all the right noises. Boosted by an English speaking population, and a comprehensive, sophisticated selection of fertility treatments and procedures that are available at significantly lower costs (and currency exchange rates) than many other fertility destinations it is no wonder that it is being seriously considered as the ‘fertility hub of Asia’.

This position has much to do with the professionalism, foresight and ability of the Malaysia Healthcare Travel Council which is able to provide a sector wide approach to medical travel. I have witnessed levels of support for the fertility traveller in many countries but although some of this support is superb it is only provided by individual clinics or groups. MHTC offer a high level of support and information to travellers and present a provider portfolio from which patients can choose the right clinic, hospital or treatment. They not only showcase the medical talent Malaysia has to offer but their collaboration with specific clinics and hospitals offers the patient reassurance regarding the quality of care each provides.

MHTC are a medical tourism facilitator but they are far more than that. They represent a medical tourism model which many other countries would do well to replicate; led by a charismatic CEO they have rightly come to ‘own’ the fertility space in Malaysia and have ensured that this niche area of medicine and science is quite rightly, beginning to warrant the recognition it truly deserves.

My advice. Why not try Malaysia. I am looking forward to it.

 

Malaysia Healthcare Travel Council (MHTC) is an agency under the Ministry of Health tasked to facilitate and promote the healthcare travel industry of Malaysia by coordinating industry collaborations and building valuable public-private partnerships, at home and abroad.

You can read more about the Malaysia Healthcare Travel Council here