Addressing inequality in fertility treatment

Ekechi, Christine

doi:10.1016/s0140-6736(21)01743-8

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…Furthermore, there is evidence to suggest that lesbian recipients report experiencing discrimination in regulated settings, including feeling as though they must justify their right to be parents, and having to repeatedly “come out” to various healthcare professionals ( 37 , 38 ). Finally, although the evidence on the experiences of Black and minority ethnic individuals is distinctly lacking, we know that they experience poorer outcomes of, and face considerable challenges in accessing, regulated fertility treatment ( 39 ). In the US, reasons for such disparity have been attributed to a mistrust of healthcare systems due to previously experienced or perceived racism, and biased assumptions by health professionals about sexual behavior and the cause of infertility in Black women ( 39 ).…”

Section: Policies and Practices In Regulated Donor Inseminationmentioning

confidence: 99%

“…Finally, although the evidence on the experiences of Black and minority ethnic individuals is distinctly lacking, we know that they experience poorer outcomes of, and face considerable challenges in accessing, regulated fertility treatment ( 39 ). In the US, reasons for such disparity have been attributed to a mistrust of healthcare systems due to previously experienced or perceived racism, and biased assumptions by health professionals about sexual behavior and the cause of infertility in Black women ( 39 ).…”

Section: Policies and Practices In Regulated Donor Inseminationmentioning

confidence: 99%

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Are UK Policies and Practices for Regulated Donor Insemination Forcing Women to Find Unregulated Sperm Donors Online? A Perspective on the Available Evidence

Taylor

Turner-Moore

Pacey

et al. 2022

Front. Glob. Womens Health

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In recent years, there has been an increase in women obtaining donor sperm via unregulated websites and social media. In this article, we bring together the disparate evidence in this emerging field to consider whether restrictive UK policies and practices for regulated clinical donor insemination (DI) are a potential explanation for the growing use of the currently unregulated, online route to donor insemination. To this end, we examine the nature of the National Institute for Health and Care Excellence (NICE) guidelines, recent data provided by the Human Fertilisation and Embryology Authority (HFEA), and prior research on who uses online sperm donation and their reasons for doing so. In addition, we highlight why this issue is important by outlining some of the benefits and drawbacks of the unregulated route. We argue that, whilst there are many factors driving the unregulated route to DI, restrictive UK policies and practices for regulated DI might be one of these. We conclude that turning our attention to structural barriers, such as regulated DI policies and practices, is necessary to produce more definitive evidence of this potential issue, and that adopting a Reproductive Justice framework could lead to more equitable provision of regulated DI services.

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Section: Policies and Practices In Regulated Donor Inseminationmentioning

confidence: 99%

Section: Policies and Practices In Regulated Donor Inseminationmentioning

confidence: 99%

Are UK Policies and Practices for Regulated Donor Insemination Forcing Women to Find Unregulated Sperm Donors Online? A Perspective on the Available Evidence

Taylor

Turner-Moore

Pacey

et al. 2022

Front. Glob. Womens Health

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“…Among women who are unable to conceive with conventional methods, a substantial number remain undertreated or untreated [1 ▪ ,67,68]. Literature spanning the course of two decades indicate that Black individuals in the US have particularly lower rates of utilization of fertility treatment options of including assisted reproductive technology (ART) [69 ▪▪ ,70 ▪ ], which is reflected in higher levels of unmet reproductive goals reported among Black women [1 ▪ ]. Data reflecting responses of an estimated population of 45,576,559 US women, revealed that despite comparable rates of infertility, Black and Mexican/American women sought infertility care less frequently than Asian or White women (40–44% vs. 65–80% P < 0.001) [71].…”

Section: Access To and Utilization Of Fertility Servicesmentioning

confidence: 99%

Racial disparities in access to reproductive health and fertility care in the United States

Beroukhim

Mahabamunuge

Pal

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTo examine the status of racial and ethnic inequalities in fertility care in the United States (U.S.) at inception of 2022. This review highlights addressable underpinnings for the prevalent differentials in access to and utilization of infertility treatments and underscores gaps in preventive care as key contributors to racial and ethnic disparities in risk burden for subfertility and infertility.Recent findingsSignificant gaps in access to and utilization of fertility care are consistently reported among racial and ethnic minorities, particularly Black and Hispanic women. Access to and utilization of contraceptives, human papilloma virus vaccination rates, preexposure prophylaxis use, and differentials in treatment of common gynecologic disorders are relevant to the prevalent racial and ethnic disparities in reproductive health. The spectrum of differential in reproductive wellness and the magnitude of reproductive health burden afflicting racial minorities in the U.S. raise concerns regarding systemic and structural racism as plausible contributors to the prevalent state of affairs.SummaryDespite efforts to reform unequal reproductive health practices and policies, racial and ethnic disparities in fertility care are pervasive and persistent. In addition to measures aimed at reducing barriers to care, societal efforts must prioritize health disparity research to systematically examine underpinnings, and addressing structural racism and interpersonal biases, to correct the prevalent racial inequities and mitigate disparities.

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“…Global sub-fertility treatments centre around expensive IVF treatments with successes of only 30% meaning 70% of women fail to have a baby, despite cumulative success claims ( Ekechi, 2021 ; Rienzi et al, 2021 ; Bahadur et al, 2020 ; Spencer et al, 2016 ). The UK NICE’s non-evidenced-based guidelines relating to IUI and IVF remain unchanged despite an expected 2017 review Bahadur et al (2017) .…”

Section: Introductionmentioning

confidence: 99%

Global inequality in sub-fertility treatment needs safer, cost effective, evidence-based and economically viable choices for patients and stakeholders

Bahadur¹,

Homburg²,

Muneer³

et al. 2022

JBRA Assisted Reproduction

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The global increase in subfertility diagnosis and treatments and the rise of private equity investors concentrating on high profits based on in vitro fertilisation (IVF) treatments raise profound societal and economic questions for stakeholders and patients. The question remains as to whose benefits will ultimately be greater when promoting high margins treatment options resulting from cross-border mergers and acquisitions of IVF clinics.This paper covers wide-ranging issues from the erroneously constructed UK National Institute for Health and Care Excellence’s (NICE) guidelines on treatment choices, the cost-effectiveness of treatments, the promotion of IVF, and add-ons where evidence remains minimal, the commercial size of the fertility industry. Investment in improving intrauterine insemination (IUI) success rates has understandably been avoided for its short-term impact on the IVF industry. However, IUI efficiency would cut across many of the global subfertility treatment economic and access problems while allowing stakeholder, feepaying, and patients financial savings will likely allow for more funded IVF cycles in acutely deserving cases. The recommendations will help expand choices for globally economically challenged patients’ and services while enhancing an ethical and moral dimension towards fertility treatment choices for patients and stakeholders.

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Addressing inequality in fertility treatment

Cited by 12 publications

References 12 publications

Are UK Policies and Practices for Regulated Donor Insemination Forcing Women to Find Unregulated Sperm Donors Online? A Perspective on the Available Evidence

Are UK Policies and Practices for Regulated Donor Insemination Forcing Women to Find Unregulated Sperm Donors Online? A Perspective on the Available Evidence

Racial disparities in access to reproductive health and fertility care in the United States

Global inequality in sub-fertility treatment needs safer, cost effective, evidence-based and economically viable choices for patients and stakeholders

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