The Rise of Infertility: A Problem Among Filipino Women
According to the Philippine Society for Reproductive Medicine, approximately 10% of the population, or a staggering 11.4 million Filipinos or 5.7 million couples will be requiring fertility services
Infertility is a seriously growing concern among Filipino women, with an increasing number of couples finding it difficult to conceive naturally. According to the World Health Organization (WHO), infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.
The numbers prove the problem. According to the Philippine Society for Reproductive Medicine, approximately 10% of the population, or a staggering 11.4 million Filipinos or 5.7 million couples will be requiring fertility services. Globally, estimates from the WHO state that approximately 17.5% of the adult population, or 1 in 6 people experience infertility. The reasons behind this are varied, spanning daily habits, environmental factors, medical issues, and the demands of modern life. As women today juggle a fast-paced lifestyle, the quiet yet growing rise in infertility highlights the need for a deeper look into its causes and possible solutions.
Dr. Aileen Marie Caluza-Buliyat, MD, FPOGS is a deemed Fellow of the Philippine Obstetrical and Gynecological Society. She completed her Residency Training in Obstetrics and Gynecology at the Baguio General Hospital and Medical Center Manila, from 2015 to 2018. She is currently an OB-GYN and Infertility Specialist practicing at Baguio City and she shares her insights and knowledge regarding this pressing matter.
On Getting Pregnant
Dr. Aileen first states a definition, “For pregnancy to happen, these steps need to occur: (a) sperm should reach the cervix around the time of ovulation and travel to fertilize the egg; (b) ovulation should happen regularly; (c) the fallopian tubes must catch the egg and transport both sperm and embryo; (d) finally, the uterus needs to be ready for the embryo to implant and grow.” According to her conclusion, “Any abnormality in one or more of these factors can bring about infertility.”
On Contributing Factors
Naturally, for women, fertility is at its peak during their 20s and starts to decline in their early 30s. When a woman reaches 35, the chances of conceiving naturally drop significantly each year. In today's society, many women are delaying motherhood to pursue higher education and establish careers. Personally, it's wonderful to see women empowered and taking control of their futures, but we need to balance career aspirations with reproductive goals. Fertility is a finite resource, and it doesn’t wait. Dr. Aileen affirms this, “As the woman ages, there is a natural depletion of follicles, causing a decline in her reproductive potential.”
For females, “Tubal issues cause about 30-40% of infertility cases. Blocked fallopian tubes can happen due to things like pelvic inflammatory disease, untreated STIs, ectopic pregnancy, or unsafe abortions,” Dr. Aileen weighs in.
Men are involved in this conversation, too. Dr. Aileen shares, “Around 30-40% of infertility cases are due to male factors, such as blockages in the reproductive tract from injuries or infections, hormone issues affecting sperm production, problems with the testes like varicoceles or effects from treatments like chemotherapy, and poor sperm quality from habits like smoking or using steroids to build muscle.”
For the remaining percentage, “20-40% of infertility cases are due to ovulation problems, often linked to conditions like PCOS and other follicle-related issues. Delaying having kids is also a big factor here. Uterine issues are less common but can include things like adenomyosis, fibroids, congenital uterine problems, and endometrial polyps.”
On Lifestyle Choices
Having been personally diagnosed with PCOS in my early 20s, I was one of the many who went through physical challenges that disrupted my monthly menstruation. I was overweight, excessively consuming alcohol and sugar, and had a sedentary lifestyle because of my high-stress desk job (I was in advertising). On top of that, I smoked, too, which has been shown to damage the reproductive system, making it harder for women to conceive. My lifestyle affected my heaviness which affected my hormonal imbalance, ovulation, and overall fertility. Realistically, the impact of weight is undeniable when it comes to infertility.
While lifestyle factors are within our control, environmental pollutants pose a hidden threat. Endocrine-disrupting chemicals (EDCs) found in plastics, pesticides, and some personal care products can mimic or interfere with hormones, leading to reproductive health problems. Exposure to these chemicals, even in small amounts, can accumulate over time and significantly affect fertility. We are surrounded by toxins that we often overlook—whether it's the food we eat, the air we breathe, or the products we use.
On Treatments and Cure
"Some ovulatory dysfunctions respond well to ovulation-inducing agents like Letrozole, sometimes paired with injectable gonadotropins. These treatments often include ultrasound monitoring and timed intercourse. Surgical removal of uterine myomas or polyps can enhance uterine receptivity, while tubal reconstructive surgery may help women with mild tubal obstruction."
However, not all cases of infertility will respond to these treatments. “In severe cases, assisted reproductive technology (ART) might be the best option, which involves handling the egg outside the body. The most common type is In Vitro Fertilization (IVF), where the sperm and egg are combined in a lab dish, and then one or more embryos are placed back into the uterus. IVF is used for issues like blocked fallopian tubes, low or no sperm, older age, endometriosis, or unexplained infertility. It has helped millions of couples worldwide, with over 10 million babies born through IVF,” as shared by Dr. Aileen.
On Prevention and Healthier Reproductive Health
“To help prevent infertility, especially from tubal issues, practice safe sex to avoid STIs. Lifestyle habits like smoking, heavy drinking, drug use, and obesity can also affect fertility, so it’s best to avoid them. Watch out for Endocrine Disrupting Chemicals, which can mess with hormones; these can be found in the environment, food, and even cosmetics, so choose products carefully.
If you have conditions like endometriosis, PCOS, thyroid issues, or irregular periods, it's wise to see a reproductive specialist early. For those planning to delay having kids, options like egg or embryo freezing can help counter fertility decline with age. Overall, maintaining a healthy lifestyle with a balanced diet, exercise, and stress management supports fertility, though some cases of infertility remain unexplained,” Dr. Aileen encourages.
As for my journey on my PCOS battle, I made the necessary changes to prioritize my overall health that seem to benefit my reproductive health. Back then, I switched to a low-carb and high-fat ketogenic diet and incorporated movement into my daily routine. On my 4th consistent day, my period was induced, and it has been more regular since then.
On Healing and Hope
Infertility is not just a physical challenge; it also comes with emotional and social implications. The Filipino culture places a high value on family, so the inability to conceive can cause feelings of inadequacy and guilt. Women often face the brunt of social expectations, with unsolicited advice and questions about when they will have children. These pressures can exacerbate stress and affect a couple’s emotional well-being, making the journey to parenthood even more challenging. We need to change the narrative and remove the stigma associated with it.
My take on it is—understand your body, know your options, and don’t be afraid to seek help if you’re struggling to conceive. The earlier you address fertility issues, the better your chances of finding a solution that works for you. The facts presented are a call to action for women, healthcare professionals, and policymakers alike. By understanding contributing factors to infertility and promoting a culture of openness and support, help can be more available to women to make informed choices about their reproductive health.
View Dr. Aileen Marie Caluza-Buliyat’s clinic schedule here.