Doc Ernest Caritativo is a physician who has taken the leap to pursue his passion in art and illustration full time. He currently works as a comic book artist, digital portrait painter and all-around illustrator and graphic designer.



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Message from the President

Romerico F. TorresMD

Onwards PSRM, Let’s go 10,000!
Globally around 2.5 Million IVF cycles are being performed annually. In Asia, the numbers are led by China with 906,840 (2016), Japan with 458,101 (2019) and India with 250,000 (2021). Closer to home, based on available data online and from colleagues, I was able to gather that Vietnam does 30-40k cycles/ year, Thailand has 11,717 (2016), Indonesia has 10,000 (2019) and Singapore has 8700 (2019).

Our country’s population currently approaches 114 Million of which approximately 10% or 11.4 Million Filipinos or 5.7 million couples will be needing fertility services and ultimately IVF. IVF has been in our country a little over 20 years. Based on latest survey initiated by ASPIRE as of last year, we had on the average 3642 cycles performed distributed among the 8 ART Clinics locally. Comparing this to the present need and to the number of cycles in the region and the rate of progress with which our ASEAN and Asian neighbors have developed their own ART landscapes, the question we have to ask ourselves is why are we lagging so far behind? Moving forward, can we challenge ourselves to go for 10,000 cycles in the next five years? And finally how do we get there? In attempting to answer this complex issue, I will try to break it down into 3 main sections.

First is to increase the number of REI/ ART specialist practitioners and improve confidence their practice of ART. The 3 fellowship programs are all in Metro Manila, where majority of the REI specialists are practicing. The disparity of cases in the regions is also glaring. Therefore, I think it would make sense to encourage centers in Visayas (Cebu) and Mindanao (Davao) to establish their own fellowship programs who will develop local talent to serve the regions. I would like to work closely with the Philippine Board of Reproductive Medicine to facilitate the establishment of these would be programs. Last year, each training program was asked to revise their curricula especially on ART, in view of the impending additional exams to be imposed by the ART board to qualify for independent practice. I would like ensure that the changes in the curricula of existing programs with regards these requirements are in order, to equip fellowship graduates with credentials to practice IVF independently. To do this we will have to reassess at least 6 months and by year end of its implementation. Each assessment will be in coordination with the ART board, and will be a living curriculum which shall be adapted and revised accordingly in tune with the requirements.

For the current practitioners and young colleagues new into practice, we will continue to hone their craft through ongoing programs such as the IVF series, the Mentor/ Mentee programs whether or not affiliated with a particular ART center/ local observership and the Local IVF Fellowship program. I was a beneficiary of the Merck Foundation which has given me an opportunity to pursue a hands on fellowship training abroad and a masters degree 3 years back. The Merck Foundation of late has partnered with PSRM in the selection of suitable candidates for the various IVF trainings that they offer with their affiliate programs. Currently we have 2 who are about to finish. This is an ongoing partnership and we look forward to the next batch of applicants. And of course we have our staple Annual and Midyear conventions and Webinars some topics of which deal with ART and reproductive medicine topics to keep us abreast with the developments in the field.

Second is to increase the number of ART centers. While cost, logistics, manpower and technical expertise on its set up are enormous hurdles these are largely addressed by those who are invested in such enterprise. Possibly from my end, I would work closely with the ART Regulatory Board and its requirements, few of which seem to limit significantly the number of centers that may be opened and subsequently accredited. For us to be able to serve ALL those who need us, we have to find reasonable solutions without compromising safety and quality. Within the next five years to fulfill the 10,000 cycles/ year, we will need 12-15 centers which means almost double the number of centers we have now.

For patients to continue to flock and believe in IVF we have to ensure quality in the product. An honest assessment of a center’s performance should include standard Key performance indices and reported in a manner that is transparent, standardized and universally accepted by all ART centers. If I were to google what is the National average pregnancy rate per cycle started, unfortunately, I wouldn’t be able to find that data. We wouldn’t be able to know how we can be better as a group, if we don’t know where we stand, we need these numbers to guide us objectively.

Thirdly we need to increase our Market base. While I was in India for my second ART fellowship, I met the largest locally manufactured global supplier of IVF equiptment. And my question to him was, why is it that IVF in the Philippines has been around for 20 years and yet we are stuck below the output of just 1 center in Vietnam or India? His answer was perhaps we haven’t reached our TIPPING POINT.

This critical moment when an event, trend, idea or product ceases to be marginal or niche and becomes massive. In other words, it has to be VIRAL in today’s lingo. So how do we reach this? Social media engagement, lay people engagement, more people talking about it the better. The more clinicians doing it, the more centers, better success rates will lead us to this. I do feel that we are at the cusp of this tipping point for which we have to be prepared for to sustain this momentum,

A final point on ART, our ART consensus guideline. I am eagerly awaiting the results of the first phase of our ART consensus guidelines from which we will base our second round of consensus gathering. It is my hope that we as a group will be able to resolve issues surrounding 3rd party ART. As a society who is the authority on the topic, we have to formulate our stand cognizant of the views of the majority, the current needs and sensibilities of the public, while keeping its core values and aspirations. In the event that the group feels the need for legislation, this will be a vital document that can guide us.

The vision of PSRM is to become widely recognized in the region. And it will be able to show its mettle by hosting its first ever international convention through the Asian Congress in Endometriosis on September 2023 and its 2nd in the following year on May 2024 with the re-emergence of ASPIRE in Manila. This gargantuan task is indeed daunting, but with Dr Songco at the helm and the organizing team and with everyone’s support I am positive we will succeed!

We are grateful and acknowledge our dear mentors who brought ART to our shores. It was a gift to both our profession and especially to patients whom it has served. They say that the greatest complement to a mentor is when the mentees go beyond what was taught to them. So I say lets go for 10,000 cycles, it’s not just going to be our gift to our mentors but to generations of practitioners and patients to come!


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