Low-birth Greece takes a further hit from crisis

ATHENS - In a nursery of a private maternity hospital in Athens, three mothers feed their newborns while another three babies nap nearby.

The room has only a few cots, and yet a number lie empty.

Sunk in recession for the past six years and struggling to steer its economy through painful austerity cuts, Greece now faces a fertility crisis as well.

"Benefits have been cut, the cost of living has risen, wages are down and there is great uncertainty," says Leonidas Papadopoulos, managing director of the Leto hospital and a veteran obstetrician.

"Couples think twice nowadays, not only for a second child but even for their first... It looks like there will be 10,000 fewer births next year," he adds, citing estimates drawn from state and private studies.

According to state statistics agency Elstat, the fertility rate in Greece has fallen from 2.33 children per woman in 1975 to 1.4 in 2011.

The replacement rate, the number of births at which the population remains stable, is 2.07 children.

Papadopoulos also cites a recent study by the University of Athens which found that the rate of miscarriages has doubled to four percent in the last two years.

And births have gone from 118,000 in 2008 to 101,000 last year, he notes.

"At this rate, Greece will be much smaller in a few years," Papadopoulos says.

The European Union fertility leader is Ireland with 2.05 births in 2012, followed by France with 2.01 children.

In one of its projected scenarios, Elstat sees the population of Greece dropping to 9.7 million in 2050 from 11.29 million in 2012.

A jobless rate of over 27 percent -- and over 30 percent among women -- compounds the difficulty facing couples today.

"Policies to protect maternity are easier to apply in good (economic) periods," says a high-ranking state welfare official who declined to be named.

"In the private sector, mothers very frequently do not make use of their rights because unemployment is very high," the official added.

In Greece's more easy-going civil service, staff can take up to 14 months in fully paid maternity leave -- and have been known to obtain extra time for difficult pregnancies.

In the private sector, mothers can on paper claim up to 15 months of non-consecutive maternity leave -- four of them unpaid -- not including holidays.

In reality, however, employees rarely push to obtain full maternity leave for fear of losing their job, officials note.

The Greek ombudsman's office highlights the problem in its latest report for 2012.

"Women who are pregnant or just back from maternity leave, run higher risks of...unemployment and precarious employment," the report said.

"In many cases they accept a violation of their labor rights to avoid losing their job," it noted, adding that having children was also likely to adversely affect a woman's pay and career prospects within a company.

"We even have extreme examples of couples who have been trying to have a child for years, undergo costly treatment and then want to have an abortion because the husband just lost his job," Papadopoulos said.

The 'money is so little that it cannot even cover bread and milk for the children'

Paradoxically, the axe has fallen the hardest on large families.

Until last year, mothers could claim a lump sum of 2,000 euros ($2,618) upon the birth of their third child, and the same amount for each child thereafter.

Then there were additional child support benefits of up to 4,700 euros a year, depending on income and the number of children, which were accessible to even moderately wealthy families.

These were eliminated in 2012 and replaced with a new, means-tested system.

From January 1, families are theoretically eligible for child support benefits of up to 5,880 euros -- but they would need to have six children and be on the verge of starvation to claim it.

Spain is a similar example of a once-generous welfare gone for good -- a 2,500-euro handout per baby was eliminated in 2011.

In Germany, parents receive 184 euros per month for their first two children. For the third child, the state pays 190 euros and for additional children 215 euros.

In Greece, even for couples who are not in dire straits, supporting a large family is tough.

"We cannot meet the needs of our three children and our parents are having to contribute from their pensions," says Georgia Kitsaki, an unemployed hotel worker from Thessaloniki.

Georgia and her husband Nikos, who is also unemployed after a labor accident, received a monthly jobless benefit of 470 euros until December, and child benefit of 276 euros. The latter has since been suspended.

"In any case, this money is so little that it cannot even cover bread and milk for the children," she adds.

source: interaksyon.com

1 in 10 Filipinos suffer infertility - study

MANILA, Philippines - One in 10 Filipinos is suffering one or more conditions that prevent them from conceiving, showed results of a study commissioned by pharmaceutical firm Merck Serono.

The study showed that while majority of couples with fertility problems seek initial consultation, treatment is hindered by patients’ perception of the high cost of treatment and lack of understanding on the procedures involved.


Merck Serono is the biopharmaceutical division of Merck KGaA with headquarters in Darmstadt, Germany.

The company released the result of the study as it embarks on a campaign to raise awareness on infertility in the Philippines and its treatment.

The campaign dubbed "Hope for Starting Families", aims to provide couples with relevant information on infertility treatment through public information efforts such as a series of lay fora across major cities nationwide, and a dedicated website on infertility such as www.fertilityphilippines.com. The website will serve as a repository of information on the causes of infertility, available treatment options as well as a directory of medical experts and treatment centers in the Philippines.

Merck said one of the barriers for treatment also stems from the misconception that treatment is not available locally, or that it is more effective in other countries.


Under its campaign, Merck informs Filipino couples that fertility treatments are available from five assisted reproductive technology (ART) centers in the Philippines and that their success rates are comparable to international standards.

According to the Philippine Society of Reproductive Endocrinology and Infertility (PSREI), Filipino couples are encouraged to seek help from fertility experts – and to do so urgently - if they truly want to realize their dream of starting a family.

"Fertility treatments are being successfully done in the country for many years now, and I am happy to report that we have helped many couples conceive with an average success rate of 30 to 50 percent," said Tim Kneen, Regional Vice President of Merck Serono in Asia Pacific.

The Hope for Starting Families campaign is aligned with Merck’s efforts across Asia, following a recent study commissioned by Merck Serono that has been endorsed by the Asia Pacific Initiative on Reproduction (ASPIRE).

Called Starting Families Asia, the study is the largest study of its kind, with 1,000 women across 10 Asian countries surveyed. The study revealed critical knowledge gaps about fertility, the key causes of infertility and fertility treatment options.

The Starting Families Asia reported less than half of the women surveyed across the region understand that a couple is classified as infertile if they fail to conceive after one year of trying (43 percent); that a woman in her forties has a lower chance of falling pregnant than a woman in her thirties (36 percent); and that a healthy lifestyle does not necessarily guarantee fertility (32 percent).

The findings could mean that many women are not seeking the help or treatment that could improve their chances of conceiving – particularly for women above age 35.

"Asian countries have among the lowest fertility rates in the world and the declining birth rates are a cause for concern. Merck Serono commissioned the Starting Families Asia study to better understand Asian women’s decision-making considerations around having a baby. It is our hope that insights from this study, which highlights critical fertility knowledge gaps that need to be addressed, will assist healthcare professionals and policy makers in addressing this acute challenge," Kneen said.

Kneen added Merck will to continue to work closely with doctors, ART centers and patients who have successfully given birth to babies through assisted reproductive techniques to produce and share updated content on significant fertility issues.  Merck will also conduct workshops on Basic Infertility Management for obstetricians and gynecologists.

source: philstar.com

Women in Asia largely ignorant on fertility issues — survey

HONG KONG - Women in Asia are largely ignorant about fertility problems and tend to blame their failure to conceive on "God's will" and bad luck, a survey has found.

The survey, which covered 1,000 women in 10 countries who had been trying to conceive for at least six months, found that 62 percent of them did not suspect they may have a fertility problem.

They were even less likely to point the finger at their husbands, with 80 percent of them not suspecting that their partners may have a problem with fertility.

Infertility is defined by the World Health Organization as the inability to conceive after a year of regular, unprotected sex. But only 43 percent of the women surveyed knew that.

Only 30 percent of the women, all aged 25-40, recognised that obesity could reduce fertility and only 36 percent knew that chances of getting pregnant declined with age.

Forty-three percent did not know a man may be infertile even if he could achieve an erection and 73 percent were unaware that men who had mumps after puberty could be infertile later on.

Instead of getting treatment, 46 percent of respondents blamed their inability to conceive on "God's will" and 45 percent put it down to bad luck.

Lead researcher P C Wong at the National University Hospital Women's Centre in Singapore said such a lack of understanding could result in couples waiting too long - only to realise when they finally decided to seek help that it may be too late.

"That's a lost opportunity because even if they come for treatment, our success of treatment is higher with younger women," said Wong, who heads the reproductive endocrinology and infertility division at the hospital.

Chances of success with in-vitro fertilisation - the best known fertility treatment - is 40-50 percent when a woman is under 30 years old but that drops to 10 percent once the woman is over 40. By 44-45, the chance of success is one percent.

"The reason is because eggs in the ovaries decline in quality and quantity ... as we go along and age, the chances of conceiving is much lower," Wong said by telephone.

The survey, commissioned by Merck KGaA unit Merck Serono, covered China, India, Japan, South Korea, Thailand, Vietnam, Singapore, Hong Kong, Taiwan and Malaysia.

Wong said his team hoped to work on a similar survey targeting men in Asia. - Reuters

source: gmanetwork.com

Moderate exercise linked to quicker conception: US study

Moderate exercise is tied to greater success among women trying to get pregnant, but those who work out vigorously take longer to conceive, an international study has found.

"This study is the first to find that the effect of physical activity on fertility varied by body mass index," said lead author Lauren Wise, a reproductive epidemiologist at Boston University. Body mass index (BMI) is a ratio of height to weight.

Researchers in the United States and Denmark followed more than 3,500 Danish women aged 18 to 40 who were trying to conceive over the course of a year for the study, published in the journal Fertility and Sterility.

All reported being in a stable relationship with a male partner and were not receiving any fertility treatments.

Participants estimated the number of hours per week they had spent exercising in the past year, as well as the intensity of their workouts. Over the course of the study, nearly 70 percent of all women became pregnant.

The researchers found that moderate exercise, such as walking, cycling or gardening, was associated with getting pregnant more quickly for all women, regardless of weight.

Women who spent more than five hours per week doing moderate exercise were 18 percent more likely to become pregnant during any given menstrual cycle than women who performed moderate exercise for less than an hour each week.

However, normal-weight and very lean women who reported high levels of vigorous exercise, such as running or aerobics, took longer to get pregnant. Those who exercised vigorously for more than five hours each week had a 32 percent lower chance of becoming pregnant during a given cycle than women who did not exercise vigorously at all.

There was no association between vigorous exercise and the time it took overweight or obese women—those with a BMI of 25 or greater—to become pregnant.

While the study was large and well designed, there were some weaknesses, said Bonnie Dattel, an obstetrician at Eastern Virginia Medical School in Norfolk, Virginia, in an email.

Because the amount and intensity of exercise was self-reported, participants could have underestimated or overestimated their activity levels, she said.

The results also don't mean exercise was responsible. Women who took longer to conceive could also have modified their exercise patterns, the researchers noted, making the relationship the opposite of what it appeared.

In general, overweight and obese women have higher rates of fertility issues and a variety of pregnancy complications, said Richard Grazi, a reproductive specialist at Genesis Fertility in Brooklyn, New York, who was not part of the study.

"Fat is metabolically active—it makes estrogens," he said.

That extra estrogen can suppress other hormones responsible for ovulation, which can lead to irregular menstrual cycles or even a lack of menstruation.

On the other hand, it's not clear why lean women who exercise vigorously may take longer to become pregnant.

Having too little body fat may be a factor for some women, and it's known that competitive female athletes and very underweight women sometimes experience menstrual irregularities.

Exercise may also affect the fertilized egg's ability to implant in the uterus. One previous study of women undergoing in vitro fertilization found a higher risk of implantation failure among women who did a lot of running or cycling.

"I recommend exercise to all my patients, and a moderate level is always best for conception and pregnancy," said Wise. –Reuters

source: gmanetwork.com