OB/GYN & Women's Health
GUIDELINE
● Guideline
Why is it so hard to get fertility help in Asia Pacific countries?
Frontiers in Medicine
Published April 1, 2026
Imagine wanting to start a family but finding the door to help is locked. That's the reality for many people across Asia Pacific countries, according to a new expert report. The analysis found that in many places, infertility isn't officially recognized as a disease. This lack of recognition has a domino effect: it leads to little government funding for fertility services, almost no insurance coverage for treatments like IVF or egg freezing, and a general public that doesn't understand the struggle.
The report, which reviewed existing literature and gathered expert opinion, paints a picture of a system that isn't set up to help. Because society often doesn't talk about infertility, people feel isolated and may delay seeking medical care for years, which can make treatment harder. There's no data here on how many people are affected or what the exact health outcomes are—this is a look at the policy landscape, not a clinical study of patients.
It's important to remember this is a guideline and review, not a trial that tested a solution. The experts are pointing out the problems and recommending that countries create better policies to make fertility care more accessible and equitable. The next step is for governments to listen and act, but this report itself doesn't measure what happens when they do.
View Original Abstract ↓
BackgroundDeclining fertility rates are a globally documented problem, affecting even regions that have historically high fertility rates. In the Asia Pacific (APAC) region, most countries and territories are seeing birth rates drop far below the replacement rate of 2.1 children per woman. Policymakers in these countries have switched from a historic focus on population control policies to investing in pronatalist policies that aim to boost the national fertility rate by tackling the socioeconomic drivers of falling fertility. In this paper, we examine policies affecting the often-overlooked medical aspect of this challenge: infertility.ObjectiveTo review challenges in fertility policy and propose solutions to improve equitable access to assisted reproductive technologies (ART) and associated services.MethodsA review of literature was conducted on fertility policy challenges and developments in the APAC region, covering fertility recognition and awareness; egg freezing; and access to ART treatment, psychosocial care, and supplementary care. Experts from nine different countries and territories were invited to validate secondary research findings and provide their perspectives on policy implications. The experts participated in individual 60-minute interviews, then a half-day Policy Forum discussion was held at the Asia-Pacific Assisted Conception Congress 2024, held in Kuala Lumpur, Malaysia.ResultsWhilst several countries in the region have long recognised falling total fertility rates (TFR) as a cause for concern, many have been slow to recognise infertility as a disease, resulting in limited policy development to support patients experiencing infertility. Commonly this presents as lack of funding allocated towards fertility services, limited or no reimbursement of fertility treatment or egg freezing, and poor societal awareness of infertility and hence delays in seeking care. Various policy changes can be adopted to improve care for patients across the APAC region.ConclusionOur review identified multiple gaps in policy development for supporting individuals experiencing infertility. Looking to countries in which the TFR dropped below replacement level many years ago, the importance of timely policy intervention before negative demographic consequences occur is critical.
