The latest retrievable data about infertility in the Philippines was made available to the public by Merck Serono, a private pharmaceutical company who commissioned the survey in 2011. The survey was conducted by Synovate in 100 participating households in the Philippines, particularly in key cities located in Luzon, Visayas and Mindanao. The survey results revealed that one out of ten Filipino couples are suffering from infertility. And these couples are not seeking treatment due to the following reasons: (1) financial constraints; (2) time constraints; and (3) the patient’s belief. Of all these, financial constraints, at 86%, is the primary reason why infertile couples are not seeking treatment. In addition to this data, the Chief of The Medical City’s Reproductive Medicine, Infertility and Gynecologic Endoscopy, Dr. Marc Anthony Ancheta, further reveals that “some 35 to 40% of a couple’s inablity to conceive a child are due to female factors; while the other 35 to 40% could be attributed to male factors.” While male factor infertility is also deserving of proper attention, it is the female factor infertility that should receive greater attention and focus in terms of treatment. Why? Because, primarily, the female’s reproductive cycle is very complex and would need months and/or years to partially identify the underlying reason/s of infertility; and second, the female’s ability to conceive naturally will fall by 50% when she reached the age of 35. Therefore, there should be urgency in treating female factor infertility in an efficient, ethical and affordable way. And these conditions can be achieved by the use of NaPro Technology.
Survey of 1,010 adults across the United States, United Kingdom, Ireland, and Canada (March 2026) who are trying to conceive, tried in the past five years, or plan to try within five years. IVF awareness is high (89%) but only 58% would consider pursuing it, a 31-point gap, the largest of any option surveyed, driven by perceptions of cost and invasiveness. 89% of women said they would prefer to try a less invasive fertility option before pursuing IVF if supported by clinical guidance; 83% would choose lower-cost options first. Metabolic health support generated the highest patient appetite of any pathway: 84% would consider it and 85% would seek more information, yet only 44% had a clinical conversation about metabolic health during their fertility journey. Mens health support showed a similar pattern (80% would consider; only 43% of men had a provider conversation). 78% said better understanding of non-IVF options would make them more likely to pursue those options first. 49% learned about their fertility options only after beginning to try to conceive; 58% wished they had received more fertility education before trying (70% among those mid-journey). 84% agreed access to multiple fertility options would increase decision confidence, the most widely endorsed statement in the survey. 80% would be more likely to stay with an employer offering comprehensive fertility coverage (85% of women); 83% said the same of insurers. Sample: mean age 34.3; 56.7% female; 36.4% reported at least one diagnosed metabolic condition; 14.7% of women reported PCOS. Recruited via CloudResearch Connect panel.
Stanford JB et al., 2022·Hum Reprod Open·
Open Access
What is the feasibility of a prospective protocol to follow subfertile couples being treated with natural procreative technology for up to 3 years at multiple clinical sites? Overall, clinical sites had missing data for about one-third of participants, the proportion of participants responding to follow-up questionnaires during time periods when participant compensation was available (about two-thirds) was double that of time periods when participant compensation was not available (about one-third) and follow-up information was most complete for pregnancies and births (obtained from both clinics and participants). Several retrospective single-clinic studies from Canada, Ireland and the USA, with subfertile couples receiving restorative reproductive medicine, mostly natural procreative technology, have reported adjusted cumulative live birth rates ranging from 29% to 66%, for treatment for up to 2 years, with a mean women's age of about 35 years. The international Natural Procreative Technology Evaluation and Surveillance of Treatment for Subfertility (iNEST) was designed as a multicenter, prospective cohort study, to enroll subfertile couples seeking treatment for live birth, assess baseline characteristics and follow them up for up to 3 years to report diagnoses, treatments and outcomes of pregnancy and live birth. In addition to obtaining data from medical record abstraction, we sent follow-up questionnaires to participants (both women and men) to obtain information about treatments and pregnancy outcomes, including whether they obtained treatment elsewhere. The study was conducted from 2006 to 2016, with a total of 10 clinics participating for at least some of the study period across four countries (Canada, Poland, UK and USA). The 834 participants were subfertile couples with the woman's age 18 years or more, not pregnant and seeking a live birth, with at least one clinic visit. Couples with known absolute infertility were excluded (i.e. bilateral tubal blockage, azoospermia). Most women were trained to use a standardized protocol for daily vulvar observation, description and recording of cervical mucus and vaginal bleeding (the Creighton Model FertilityCare System). Couples received medical and sometimes surgical evaluation and treatments aimed to restore and optimize female and male reproductive function, to facilitate in vivo conception. MAIN The mean age of women starting treatment was 34.0 years; among those with additional demographic data, 382/478 (80%) had 16 or more years of education, and 199/659 (30%) had a prior live birth. Across 10 clinical sites in four countries (mostly private clinical practices) with family physicians or obstetrician-gynecologists, data about clinic visits were submitted for 60% of participants, and diagnostic data for 77%. For data obtained directly from the couple, 59% of couples had at least one follow-up questionnaire, and the proportion of women and men responding to fill out the follow-up questionnaires was 69% and 67%, respectively, when participant financial compensation was available, compared to 38% and 33% when compensation was not available. Among all couples, 57% had at least one pregnancy and 44% at least one live birth during the follow-up time period, based on data obtained from clinic and/or participant questionnaires. All sites reported on female pelvic surgical procedures, and among all participants, 22% of females underwent a pelvic diagnostic and/or therapeutic procedure, predominantly laparoscopy and hysterosalpingography. Among the 643 (77%) of participants with diagnostic information, ovulation-related disorders were diagnosed in 87%, endometriosis in 31%, nutritional disorders in 47% and abnormalities of semen analysis in 24%. The mean number of diagnoses per couple was 4.7. LIMITATIONS The level of missing data was higher than anticipated, which limits both generalizability and the ability to study different components of treatment and prognosis. Loss to follow-up may also be differential and introduce bias for outcomes. Most of the participating clinicians were not surgeons, which limits the opportunity to study the impact of surgical interventions. Participants were geographically dispersed but relatively homogeneous with regard to socioeconomic status, which may limit the generalizability of current and future findings. Multicenter studies are key to understanding the outcomes of subfertility treatments beyond IVF or IUI in broader populations, and the association of different prognostic factors with outcomes. We anticipate that the iNEST study will provide insight for clinical and treatment factors associated with outcomes of pregnancy and live birth, with appropriate attention to potential biases (including adjustment for potential confounders, multiple imputation for missing data, sensitivity analysis and inverse probability weighting for potential differential loss to follow-up, and assessments for clinical site heterogeneity). Future studies will need to either have: adequate funding to compensate clinics and participants for robust data collection, including targeted randomized trials; or a scaled-down, registry-based approach with targeted data points, similar to the multiple national and regional ART registries. Funding for the study came from the International Institute for Restorative Reproductive Medicine, the University of Utah, Department of Family and Preventive Medicine, Health Studies Fund, the Primary Children's Medical Foundation, the Mary Cross Tippmann Foundation, the Atlas Foundation, the St. Augustine Foundation and the Women's Reproductive Health Foundation. The authors declare no competing interests. The iNEST study is registered at clinicaltrials.gov, NCT01363596.
Recent studies on fertility awareness among the reproductive population have reported the lack of accurate knowledge about fertility and assisted reproductive technologies. However, there has been little information regarding women trying to get pregnant at home. The aim of this study was to explore the prevalence of subclinical infertility among women trying to get pregnant at home, and to evaluate awareness regarding infertility and reasons for not visiting infertility clinics among women who use pregnancy-assist mobile applications to help them conceive. A total of 2084 Japanese women responded to this online survey. We selected 1541 women according to the study criteria. Based on the results of 61 questions, we evaluated knowledge regarding fertility, prevalence of subclinical infertility, and reasons for not visiting the clinic among the participants. Despite the desire to conceive, the participants had an apparent tendency to overestimate the age limit for childbearing. A total of 338 (21.9%) women answered that in general women aged > 45 years could get pregnant. Approximately 40% of the women had possible subclinical infertility and were unaware of the fact. Additionally, about 70% of the women considered themselves to have infertility problems. Women who were aware of the possibility of infertility hesitated to visit the clinic due to unfamiliarity with a gynecologist or clinic, and apprehensions about the gynecologic examination. In our study, some women required treatment for infertility. Nonetheless, they hesitated to visit an infertility clinic. Sexual health education, together with proper accessibility to gynecology clinics, are necessary to reduce involuntary childlessness.
Ethics Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org, 2021·Fertility and sterility
In the United States, economic, racial, ethnic, geographic, and other disparities prevent access to fertility treatment and affect treatment outcomes. This opinion examines the factors that contribute to these disparities, proposes actions to address them, and replaces the document of the same name, last published in 2015.