Infertility care shows inequality around the world

Infertility care is hugely variable around the world with inadequate care in many countries, according to a new World Health Organization backed report.

It was written by Dr Purity Njagi at Maastricht University, The Netherlands, with funding from the World Health Organization.

They examined the research over the last 20 years on the costs of assisted reproductive technology and how governments vary in their approach to financing this care.

The team also examined links between the medical costs paid by patients and each country’s Gross Domestic Product or average income.

Findings appeared recently in Human Reproduction Open. The authors point out that about 17.5% of the adult population worldwide experience infertility.

They write: “Infertility treatment is largely inaccessible to many people in low- and middle-income countries.”

No previous study has compared assisted reproductive technology medical costs internationally against country-level economic indicators.

Their analysis found: “Significant inequities in access to assisted reproductive technology”, with many patients in low- and middle-income countries “still unable to afford it due to prohibitive costs”.

“Better policies and government financial mechanisms are needed to improve affordability for patients in low- and middle-income countries,” they conclude.

Director-General at the World Health Organization, Dr Tedros Adhanom Ghebreyesus, commented: “The report reveals an important truth – infertility does not discriminate.

“The sheer proportion of people affected show the need to widen access to fertility care and ensure this issue is no longer sidelined in health research and policy, so that safe, effective, and affordable ways to attain parenthood are available for those who seek it.”

Njagi, P. et al. Financial costs of assisted reproductive technology for patients in low- and middle-income countries: a systematic review. Human Reproduction Open 1 March 2023; doi: 10.1093/hropen/hoad007


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