Challenges for assisted reproduction and secondary infertility in Latin America

Abstract

TRANSLATED BY ALLISON B. WOLF . . . and the feminists understand perfectly that infertility carries a heavy burden for women. However, they have ambivalent feelings in relation to supporting them in their search for treatments that will resolve their infertility because they feel as if they would be contributing to reinforcing traditional gender roles. It is this tension that has strongly framed the relationship between those who are in favor of these assisted reproductive technologies . . . and feminists [.]

Cross-border reproductive healthcare

“…Although -I would arguein some cities, countries, or social groups, the value of motherhood trumps religious disapproval. Having a family and motherhood are so important within these countries that people are willing to do everything they can to secure this, and, in some cases, they feel tremendous pressure to embark on the "moral odyssey" (Herrera, 2020), they must undergo an obstacle course (Franklin 1997) and they must "pilgrimage" through clinics (González-Santos 2016), because "every women who wants to become a mother 'must' try them" (Luna and Wolf 2014). Florencia Herrera's paper "'I did everything humanly possible': The process of making reproductive decisions in the context of assisted reproduction in Chile" depicts the "moral odyssey" 32 people embark on in order to have a family.…”

“…The fact that infertility and thus ARTs are not considered a high priority within the public sector, makes access to AR services highly stratified, something called out by activists and scholars (for example, in Mexico GIRE is very vocal in this respect, see GIRE 2013GIRE , 2015GIRE , 2017. However, if the public healthcare system does cover AR treatments, there is also a considerable amount of criticism, mostly focusing on the high costs of these treatments and the implications this has for a limited and insufficient budget: "the same funds could be directed towards other areas of health that would be a higher priority to the population" (Luna and Wolf 2014). This situation feeds into and is fed from the existing misconception mentioned above that only rich people face infertility.…”

“…Restricting the availability of AR in the public health system has led to fewer people using them (Zegers-Hochschild et al, 2020) and a decrease in the possibility of regulating these services (Luna and Wolf 2014). As noted by Luna, it is easier for the states to regulate the public services, for example, placing limits to the number of cycles and embryos transferred per cycle, but when AR is mostly practiced privately, the state's involvement is more problematic.…”

“…Beyond this, in the private sphere couples can easily change providers (which encourages providers to accede to the demands of the women or couples). (Luna and Wolf 2014) Family Planing. People began using ARTs in Latin America in the eighties, when the family planning discourse and its policies were central to the reproductive debates being held in the region.…”

Philosophical Feminist Bioethics

“…Examples of uncovering and addressing injustice can be identifi ed in some recent literature. There has been work on using reproductive technology to help women made infertile by inadequate sexual health provision, 80 efforts to champion abortion rights when such rights are in danger of being surreptitiously overridden, 81 explorations into medicalization, 82 , 83 discussions on mental health prejudice within the medical system, 84 , 85 and calls to consider the absolutely, not just relatively, vulnerable. 86 , 87 This trend is also evident in the fi eld of public health ethics, in which the focus is less on fi xing the health of individuals and more on securing the health of the collective.…”