Fertility treatment for PCOS (now called PMOS): the step-by-step path and what it costs

Key facts

First-line medicine

Letrozole (Letoripe, Femara), prescription only

Typical PH cost

₱107 to ₱356.75 per letrozole tablet; cycle cost depends on dose

Evidence (2023 Guideline)

●●●Strong evidence for letrozole

Time to see results

Per cycle, with monitoring

Who to see

OB-GYN first, then a fertility specialist (reproductive endocrinologist)

PhilHealth

Does not cover IVF or other assisted reproduction

The treatment ladder with Philippine costs

The 2023 Guideline's fertility algorithm starts with the simplest, cheapest steps. Most people do not need to climb all the way.

1. 1

   Preconception checks

   Folic acid, a 75 g OGTT for blood sugar, blood pressure, healthy eating and movement at any weight, and your partner's semen analysis. Confirm whether you ovulate.

   PH cost: OB consult from ₱850 per consult; fertility hormone panel ₱4,330 per package; OGTT ₱500 per test; semen analysis [TODO: verify price]

2. 2

   Letrozole (first line)

   The first-line medicine for ovulation induction when there are no other infertility factors (Rec 5.3.1). Taken as tablets for a few days early in the cycle, with monitoring.

   PH cost: ₱107 to ₱356.75 per 2.5 mg tablet (Letoripe to Femara). The cost per cycle depends on the dose your doctor sets.

3. 3

   Clomiphene (Clomid), with or without metformin

   An alternative ovulation medicine, alone or with metformin (Rec 5.4). Sold in the Philippines as Ova Mit and generic clomifene.

   PH cost: ₱100.75 to ₱150.50 per 50 mg tablet. The cost per cycle depends on the dose your doctor sets.

4. 4

   Gonadotrophins or laparoscopic ovarian drilling (second line)

   Hormone injections with close ultrasound monitoring, or keyhole surgery on the ovaries. The NHS notes ovarian drilling can sometimes increase the chance of getting pregnant. IUI may be discussed at this stage.

   PH cost: Gonadotrophins [TODO: verify price]; IUI [TODO: verify price]; fertility specialist consult ₱1,400 per consult at Kindred

5. 5

   IVF (third line)

   In vitro fertilisation at a fertility centre. PhilHealth does not cover IVF or other assisted reproductive technologies.

   PH cost: ₱200,000 to ₱500,000 per basic cycle, plus ₱50,000 to ₱150,000 for medicines

Letrozole vs Clomid (clomiphene)

Both are tablets that help the ovaries release an egg (ovulation inductionovulation induction: Using medicine such as letrozole to help the ovaries release an egg.). The 2023 Guideline makes letrozole the first choice for anovulatory infertility with no other factors (Rec 5.3.1) and keeps clomiphene as an alternative, alone or with metformin (Rec 5.4). Many Filipino doctors still prescribe clomiphene; it is reasonable to ask, “Is letrozole an option for me?”

Prices are per tablet. How many tablets a cycle needs depends on the dose your doctor sets, so we do not give a single per-cycle figure. Generic and brand letrozole contain the same medicine; ask whether the cheaper one is fine for you. Both need a prescription and monitoring, usually with ultrasound, so add consult and scan costs (see the cost guide).

When to see a fertility specialist

• Now, if you are not ovulating (periods months apart, or none). You do not need to wait 12 months.
• Sooner if you are 35 or older. Ask your OB-GYN for a referral rather than waiting a full year. [TODO: source] for a specific interval.
• Under 35 with regular cycles: after 12 months of trying.
• Now, if your partner's semen analysis is not normal, or if ovulation medicines have not worked.

Kindred lists a fertility and reproductive endocrinology consult at ₱1,400 per consult. Our doctor directory lists community-recommended OB-GYNs and specialists.

IVF costs in the Philippines

IVF is the third-line option. Prices vary by clinic tier, and medicines are extra. PhilHealth does not cover IVF; it may cover related surgery, such as ovarian cyst removal or laparoscopy, when medically indicated. Per-clinic prices: [TODO: verify price].

Fertility clinics

Booking a consult is often the fastest way to get a plan. These links go to clinic pages:

Other centres named in Philippine directories include Kato Fertility Center and Conceive IVF Manila, Makati Medical Center, Asian Hospital, Victory A.R.T. Laboratory and Repro Optima Center for Reproductive Health. We list them for information only, not as endorsements.

Fears

Safety and things to stop or check

This guide is for information. Talk to a doctor before starting or changing any treatment.