Infertility Incidence in the Philippines

To determine the incidence of infertility in the Philippines, Merck Serono commissioned a study to determine the incidence of infertility in the Philippines. Conducted in 2011, the study estimates that one in 10 Filipino couples have difficulty in conceiving. It was further discovered that the highest incidence rates occur in Manila, and within an older age group consisting of females at an average age of 36.

According to the study, most infertility patients are aware of Assisted Reproductive Technologies (ART) and are generally willing to try them. However, In Vitro Fertilization (IVF), a form of ART, is seen only as a last resort, with majority of IVF patients preferring to travel abroad for treatment rather than seek IVF treatment locally.

Filipino patients can be assured that ART treatment, including IVF, is available in the Philippines through five treatment centers that specialize in a wide range of ART procedures. These centers deliver world-class services and have achieved significant success rates for pregnancy.

But before embarking on a journey to start a family, it is best to understand the factors that affect fertility. There are several reasons for delayed pregnancies; but with the local accessibility and success of ART, there is new hope for couples as they take positive steps toward their dream of starting a family.

The Problem of Infertility

Infertility is defined as the inability to conceive after one year of trying. However, there is no time to wait for couples of advanced age – especially if the female is over 35 – in which case, most practitioners initiate diagnostic evaluation after just 6 months of trying.

Fertility problems can affect both male and female, and therefore should not be cause for blame or fault. There are many lifestyle factors that may slow conception such as stress, poor diet, lack of exercise, drug and alcohol intake, use of anabolic steroids and smoking.  Firstly, these behavioral variables can and should be adjusted if a couple wants to have a baby. The ability to conceive may also be affected by environmental or occupational hazards such as exposure to various toxins or chemicals such as lead; or those found in medical materials or pesticides; or radiation from chemotherapy and x-rays.

Male fertility problems are the primary diagnosis in approximately 25% of cases and contribute to a further 15-25% of the remaining cases. In men, the most common fertility issue is the production of healthy, sufficient and mobile (moving) sperm.

There are also several common disorders that may slow conception:

Ovulation disorders:	Undescended testicles:
The normal ovarian cycle is so complex that even small changes may disrupt the cycle and prevent ovulation. Ovulatory disorders are one of the most common reasons why women are unable to conceive, and account for 30% of women's infertility. In most cases, problems are caused by a hormonal imbalance: the body may not produce enough of a particular hormone or fail to release a hormone at the right time. Scarred ovaries, premature menopause and unruptured follicle syndrome can be a problem. Ovulation may also be thrown off by significant changes in weight, either lost or gained.	As a baby boy develops in the uterus, his testicles typically form inside his abdomen and descend into the scrotum shortly after birth. When the move doesn’t take place, the baby is born with a condition known as cryptorchidism. Usually the testicles descend themselves by the sixth month of life. Untreated, undescended testicles may affect fertility or lead to other medical problems.
Fallopian tube disorder:	Varicocele:
Damage to the fallopian tubes can prevent the sperm and egg fusing. Reasons may include: • Inflammation in the region • A previous ectopic or tubal pregnancy • Scarring caused by surgery • Endometriosis	Varicocele is the presence of varicose veins around the testicles. It occurs when blood does not circulate out of the testicles properly. The increase in blood leads to a rise in the temperature in the testicles. This causes abnormal testosterone levels, which hinder the production of sperm.
Endometriosis:	Mumps:
Endometriosis occurs when cells that normally line the uterine cavity grow in areas outside of the uterus (i.e. fallopian tubes, ovaries, bladder or intestines), creating an adverse environment in these unsuitable organs. Its cause is largely unknown.	Contracting mumps after puberty may damage sperm-producing cells in the testicles in most cases, only one testicle is affected. Some men suffer permanent sterility.
Problems with the uterus or cervix:	Surgery or injury:
Sperm may fail to reach the egg if scarring caused by surgery, blockage or inflammation, reduces access to the cervix. A myoma or fibroid (a benign tumor in the uterus) may be the cause of persistent fertility problems or miscarriage. Conditions such as polyps and adenomyosis may also lead to obstruction of the uterus and Fallopian tube. Abnormal cervical mucus can also cause difficulty, wherein the female's cervical mucus is of poor consistency or inadequate in amount for sperm to swim easily within.	Serious trauma to the testicles can affect the production of sperm and possibly lead to sterility. Damage from sport or by accident can rupture vessels that supply blood to the testicles. Additionally, surgery to correct an undescended testicle or repair a hernia may lead to damage of a man’s sperm producing capabilities.
Reproductive malformations:	Physical abnormalities:
In very rare cases, conception difficulties are caused by congenital irregularities with the reproductive system that could affect the shape and size of the uterus, the fallopian tubes, the vagina or a combination of these.	In a small number of men, the fluid deposited in the vagina during intercourse may not contain sperm. This may be due to a blockage or malformation of the epididymis, which prevents the sperm from combining with other fluids to create semen.
Polycystic Ovarian Syndrome (PCOS):	Testicular cancer:
Multiple cysts can form in the ovaries. In most cases, this disorder is associated with a high level of male hormones and ovulation disorders.	Testicular cancer is sometimes diagnosed when a couple is experiencing difficulties conceiving. A malignant tumor that develops in the testicle may destroy testicular tissue. If not detected early enough it may also spread to other parts of the body.
Immune system disorders:	Diabetes:
On rare occasions, an impaired immune system may treat the egg or sperm as a “foreign body”, and attack it as an “intruder”.	Diabetes has been found to have an effect on the quality of sperm.
	Overheating:
Source: http://fertilityphilippines.com/fertility-facts/	Heat can have a detrimental effect on normal sperm production. Too much time spent soaking in a hot tub can raise the temperature of the testicles and temporarily impair sperm production.