News and Updates

Fertility rates are declining in nearly every country with notable exceptions in sub-Saharan Africa. 

Interestingly, research (Eisenberg et al, 2021) in the United States has demonstrated that while fertility rates in that country are in decline, biological fecundity – meaning the physiological ability to conceive among reproductive age women in the general population – has remained relatively stable. 

On a global scale falling total fertility rates are primarily the result of socio-economic factors and the growing number of women in the workforce.

A study by C. Goldin (Goldin, 2006) highlighted that engagement of women in the workplace exposed many to a dual burden.  On one side, they had tasks for work for which they were paid, and on the other side they were left with domestic duties for which they were not compensated.  

Goldin emphasised that fertility rates had more profoundly dropped in southern European countries where men’s involvement at home was limited.  Conversely, total fertility rates remained higher in Nordic countries where men were typically more involved in domestic tasks.  

In her book Father Time, American anthropologist and primatologist, Sarah Blaffer Hrdy, highlights the benefits that men encounter when being involved in infant care.  These include hormonal elevations that control well-being and pleasure.

Enacting paid parental leave for fathers and mothers encourages the involvement of men in infant care.  

In all, we believe the current fertility decline is not necessarily bound to be definitive.  Indeed, there is hope that the The Time of Men will bring a resurgence in natality (de Ziegler et al, 2026).

References

de Ziegler D, Sean S, Toner JP. ‘The Time of Men: Can their involvement in the domestic sphere revive birth rates?’ Fertil Steril. 2026.

Eisenberg ML, Thoma ME, Li S, McLain AC. ‘Trends in time-to-pregnancy in the USA: 2002 to 2017’. Human Reproduction. 2021;36(8):2331–8.

Goldin C. ‘The quiet revolution that transformed women's employment, education, and family’. American Economic Review. 2006;96(2):1–21.

I am delighted to share the latest developments in reproductive medicine in Hong Kong, a period marked by significant strides in public policy and clinical accessibility. 

The most transformative update in our field is the Government’s proactive measures supporting family planning to address the city's demographic challenges. 

The successful implementation of the Assisted Reproductive Services tax deduction, which allows couples to claim up to HK$100,000 (about US$12,800) annually for IVF and related treatments, has substantially alleviated the financial burden on our patients. 

This landmark policy has driven a notable increase in clinical consultations and fostered a more open, supportive societal dialogue surrounding infertility.

Dr David Y. L. Chan
ASPIRE Country Representative for Hong Kong

Despite our relatively small population, New Zealand continues to punch well above its weight in reproductive medicine by making significant contributions across clinical research, digital health, imaging and artificial intelligence. 

Strong collaborations between fertility specialists, embryologists, scientists, engineers and industry partners are driving innovation that is influencing both local practice and the wider fertility community.

A recent highlight has been the work of researchers from the University of Auckland investigating embryo-derived extracellular vesicles (EVs) as potential non-invasive biomarkers for embryo assessment. 

Supervised by Dr Lynsey Cree, the systematic review evaluated 32 studies and concluded that while EVs remain a promising area of research, there is currently insufficient high-quality evidence to support their routine clinical use in predicting embryo competence or IVF outcomes. 

The review, recently published in Human Reproduction Update, provides an important evidence-based framework for future research in this rapidly evolving field.

Artificial intelligence is another area where New Zealand researchers are having a growing impact. The Auckland team recently presented work at the 2026 ESHRE meeting in London demonstrating how AI-powered quantitative image analysis can provide new insights into blastocyst expansion dynamics and embryo development. 

This work has been enabled through WyldBloom, a New Zealand-developed AI platform created through collaboration between clinicians, embryologists, researchers, engineers and Fertility Associates. 

Beyond supporting automated embryo assessment and laboratory quality monitoring, AI is helping generate new scientific knowledge by transforming embryo evaluation into objective, quantitative measurements that can be studied at scale.

Our clinical research community also remains highly active. Dr Lucy Prentice continues to lead important work examining treatment options for unexplained infertility, including randomised controlled trials, treatment tolerability research and systematic reviews comparing IUI and IVF outcomes. 

Her work includes cost-effectiveness analyses of fertility treatments and involvement in a pilot randomised trial evaluating surgical management of minimal and mild endometriosis with fertility outcomes as a key endpoint. 

National collaborative efforts are also underway to develop evidence-based approaches to BMI thresholds for access to fertility treatment.

Professor Cindy Farquhar (CNZM) continues to champion evidence-based practice across Australasia. Her current work includes leading guideline development for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) helping ensure clinical care remains grounded in the best available evidence.

At a policy level, the Advisory Committee on Assisted Reproductive Technology (ACART) is currently reviewing guidelines surrounding preimplantation genetic testing (PGT), particularly PGT-M. 

As seen in many jurisdictions, scientific advances continue to move at extraordinary pace often challenging existing regulatory frameworks. ACART’s work will help ensure New Zealand maintains a balanced approach that supports innovation while upholding ethical standards and patient-centred care.

Dr Andrew Murray
ASPIRE Country Representative for New Zealand

At the recent ESHRE meeting in London the ASPIRE Reproductive Genetics SIG highlighted the growing need to expand PGT beyond chromosome copy-number analysis by integrating genotype analysis into routine embryo testing.

Genotype-integrated PGT can:

• detect clinically important abnormalities that conventional PGT may miss including triploidy and genome-wide uniparental disomy (gwUPD) and prevent sample/embryo mismatch; and
• provide more comprehensive embryo genetic evaluation within a single workflow by a genotyping-integrated PGT platform (PGT-Plus)

Clinical implications

Integrating genotype analysis with conventional PGT has the potential to broaden embryo genetic screening, improve embryo selection and identify the parental origin of triploidy. This can provide a better understanding of the complications and risk for maternal gestational trophoblastic disease.

A recent study from the Chinese University of Hong Kong demonstrated the clinical feasibility of PGT-Plus. Outcomes included:

• improved diagnostic yield: PGT-Plus identified an additional 2.2 per cent of genetic abnormalities compared with conventional PGT; and
• explaining implantation failure. Among embryos previously classified as "euploid" by standard testing, but resulting in failed implantation, more than 3 per cent were subsequently found to harbor triploidy (0.8 per cent) or gwUPD (1.4 per cent).

(https://academic.oup.com/hropen/article/2026/3/hoag044/8687831)

ASPIRE members in the Philippines are preparing for the annual congresses of our local societies.

These include the Philippine Obstetrical and Gynaecological Society, the Philippine Society for Reproductive Medicine, the Philippine Society for Fertility Preservation and the Philippine Society for Climacteric Medicine.

Organising committees, speakers, moderators and scientific teams across the country are working tirelessly to ensure the success of these meetings. Months of careful planning and collaboration go into developing scientific programs that are timely, relevant and beneficial to our members and patients.

Beyond the scientific sessions, these congresses provide valuable opportunities to strengthen professional relationships and foster meaningful collaborations. They bring together colleagues from different medical specialties, creating an environment where knowledge and expertise can be shared across disciplines.

The meetings also serve as an excellent platform to establish partnerships with fellow reproductive medicine societies and allied organisations. We are particularly grateful for the participation of our distinguished international faculty and foreign delegates whose insights enrich our discussions and broaden our perspectives.

Through these interactions we continue to build bridges that advance education, research and clinical practice in reproductive medicine.

As we look forward to these congresses, we remain committed to working together in the spirit of excellence, innovation and regional cooperation for the benefit of the patients and communities we serve.

Dr Anthony Marc B.  Ancheta & Dr Rudie Frederick Mendiola 

ASPIRE Country Representative for Philippines

India is characterised by remarkable diversity, innovation and a shared commitment to advancing reproductive health through excellence in clinical care, research, education and collaboration.

The field of reproductive medicine is evolving at an unprecedented pace driven by breakthroughs in assisted reproductive technologies.

To help keep at the forefront of advances, the Indian Society of Assisted Reproduction (ISAR) has started the Integrated Symposium on Infertility, Gynaecology, Hormones and Technology (INSIGHT) certificate courses. The three-day courses are presented every two months.

To date we have completed two INSIGHT certificate courses on implantation and  recurrent implantation failure (RIF). The next course on endometriosis will be held from 19 to 21 August between 6.00pm and 9.00 PM.

Meanwhile, ISAR’s special interest groups have been active with full-day webinars on embryology, fertility preservation and imaging. These successful webinars will continue with a focus on reproductive endocrinology, RIF, male infertility and endometriosis.

The ISAR Annual Conference will be held between 4 and 7 February 2027 in Bangalore, India. It will provide an interactive platform for all faculties practising reproductive medicine and we look forward to welcoming delegates from across the Asia Pacific region.

For more information go to www.isarindia.net

Dr Madhuri Patil
ASPIRE Country Representative for India