BUILDING up a happy and healthy family by raising an endearing baby is a coveted reverie for many Filipinos. The newborn babies are said to be the ‘first bundle of joy’ for families, however, this joy or happiness is frustrated and dashed by fertility issues among some couples. As we should ‘go forth and multiply’, this problem seems to be the ‘x’ or it hinders multiplication of people.
The World Health Organization (WHO) describes infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”.
Dr. Virgilio M. Novero Jr., head of the Center for Advanced Reproductive Medicine and Infertility (CARMI) of the St. Luke’s Medical Center- Global City added, “It is a failure to conceive with unprotected intercourse after one year for people aged above 35 years old and after six months for people below 35 years old or certain co-morbidities”.
Furthermore, 14-15 percent of couple in the reproductive age in western countries in the world has vast incidences of infertility. In the Philippines, the United Nations Development Programme (UNDP) on 2003 confirmed 7.9 percent of Filipinos are hugely affected of the reproductive condition. Additionally, “one out of ten Filipinos are suffering from infertility according to a Synovate survey conducted in 2011” said Novero. “This condition is related to socio-cultural practices, including the marrying age, educational status, and professional goals”.
Aside from the socio-cultural factors stressed by Novero, a couple’s infertility problem tends to be inspired by health issues in the female and male reproductive systems and also as with variety of medical conditions that can affect and influence the quality of the egg and sperm cells.
Moreover, the categories of the causes of infertility is explained by WHO as pure female factors with 35 percent that includes tubal factors, ovulation disorders, endometriosis, advanced maternal age, and uterine factors. With 30 percent, pure male factors such as causes like primary testicular disease, secondary testicular disease, and sperm transport disorders, sexual disorders and idiopathic sperm abn rank second while twenty-seven percent of the categories of causes of the disease came from the combined female and male factors. Lastly, seven percent of the unexplained fertility is due to the absence of the most common specific factors causing infertility.
For evaluation of the infertile couples, it is centrally vital to classify the specific causes to be able to execute the appropriate treatment methods. Some basic tests and procedures to establish the cause are pelvic sonography and hysterosalpingogram for the wife and semen analysis for the husband. For ancillary tests, hormonal tests, ovarian reserve tests, SISH, karyotype, and special imaging can be performed for wives and hormonal tests, biomolecular tests, karyotype, and sperm function tests for husbands to determine the cause. Depending on the causes defined, medical treatment methods including hormonal and non-hormonal, surgical procedures including endoscopy, ovulation induction including tablets and injectables, artificial insemination including IUI, and ART with IVF and its variants can be unreservedly undertaken.
In addition, when age advances, fertility decreases – this is why seeking fertility treatment early enough is highly significant. “Instead of just giving up their dreams of having a child, there are modern and effective ways to address infertility”, stressed Novero. “A couple can come in for a series of basic and ancillary tests to determine the root cause of their fertility issues, and we can help develop a treatment plan that will deliver their desired result: pregnancy”.
The Science of ART
Assistive Reproductive Technology (ART) is an umbrella term that refers to in-vitro fertilization (IVF) and its variants. In 1979, the first IVF baby was born in the name of Louise Brown of the United Kingdom.
This special fertility treatment procedure stimulates multiple ovarian follicles and facilitates egg cell retrieval. During the course of treatment, embryos will be formed outside of the female patient’s body – and once the “cultures” have formed successfully, they will be transferred to the patient’s uterus.
Additionally, ART is greatly recommended for patients suffering from blocked fallopian tubes, severe sperm deficits, unexplained infertility, mild endometriosis, and ovulation disorders, among others. Though not unheard for many Filipinos, IVF is frequently seen as risky, needlessly expensive, and exclusive to those who can get the procedure done abroad, and worse, ineffective.
Novero said that the success rate of the procedure has also recently depicted a noteworthy rise today. To support this, after consistent observance of IVF procedures in numerous parents in many countries all over the world, over six million children were born, Novero added.
“Our success rates are now at 35 percent for pregnancy and 20 to 25 percent for live births”, Novero highlighted. ‘The success rates depend on the patients’ profile, the competence of the medical staff, the quality and standards of the IVF lab, and of course the use of cutting edge technology. At CARMI, our patients can be assured that we have a team of highly trained and experienced medical staff, a state-of-the-art IVF lab, and modern technology that can increase the success rate of pregnancy and live birth”.
Thus, this is considered as one of the medical solutions that childless Filipino couples can exclusively try and explore. Also, Dr. Novero explained that ART has made major improvements on competence and efficiency over the years. This includes new discoveries in hormonal treatment, intracytoplasmic sperm injection (ICSI), improved in vitro culture of embryos, laser assisted hatching, preimplantation genetic diagnosis and screening (PGD/PGS), and time-lapse videography are many of the technological advances that have improved the efficiency of IVF.
“In the past, doctors can only recommend IVF to a select few”, said Novero. “But in the recent years, technological advances, including new knowledge in hormonal treatment, improvement in video technology and other medical equipment has boosted IVF’s efficiency”.