IVF in Developing Economies and Low Resource Countries: An Overview

Abstract

Despite a record of 5 million IVF babies born in the world, the treatment of infertility by effective methods remains largely the preserve of developed countries [1]. Most infections causing tubal damage are preventable, and assisted conception can treat the infertility. However, assisted conception, despite being available for nearly three decades, is either unavailable or inaccessible to most residents of resource-poor countries. Provision of assisted reproductive technology (ART) to overcome both female and male infertility is in line with the reproductive rights agenda developed at the International Conference on Population and Development (ICPD) at Cairo 15 years ago [2]. In addition to the right to control fertility, reproductive rights must encompass the right to facilitate fertility when fertility is threatened. Facilitation of fertility may require resort to ART among both men and women. There is an increased need for low-cost procedures in treating infertility particularly in developing countries. One of the United Nation’s Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of ART in low-resource countries. Murage et al. [3] conducted a survey in a developing country (Kenya) to gage the extent of subfertility and the current state of ART service provision and explore factors limiting access to ART services. A total of 47 responses (25 %) were received after completion of the survey. The overall rate of sub-fertility was 26.1 % among the gynecology consultations, with 50 % being attributed to tubal factors and 15 % to male factors. Assisted reproductive service provision (IVF/intracytoplasmic sperm injection) was severely limited to only three units, despite the reported high rate of tubal disease [3]. The high cost of treatment, patients’ limited finances, and limited local services were almost universally cited as the main barriers to ART services in Kenya. The authors summarized that the demand for ART in developing countries is never in doubt. Simplified, less costly, and more accessible ART approaches need to be considered in developing countries, even though the benefits and outcomes of such approaches may not be apparent immediately [3].