Cost‐effective approaches to in vitro fertilization: Means to improve access

Hovatta, Outi; Cooke, I. D.

doi:10.1016/j.ijgo.2006.04.012

Cited by 26 publications

(18 citation statements)

References 30 publications

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“…An alternate approach as suggested by Hovatta and Cooke would be to set up satellite centres in semi-urban or rural areas with support from established ART centres (Hovatta and Cooke, 2006). Although attractive, it is unlikely that satellite units will offer ideal laboratory conditions.…”

Section: Discussionmentioning

confidence: 99%

Affordable ART: a different perspective

et al. 2011

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background: Although 10% of the population is affected by infertility, the treatment option of in-vitro fertilisation (IVF) remains unaffordable for the majority of infertile couples. We have initiated a low cost programme incorporating an uncommonly used, but recognized, ovarian stimulation protocol, together with certain cost limiting initiatives in an established assisted reproductive technology (ART) set up. methods:The medical records of women who underwent the low cost programme were analysed. Clomiphene citrate 50 mg daily was administered from Day 2 of the cycle and continued till the day of hCG trigger, thus preventing the LH surge. Intermittent doses of human menopausal gonadotrophin 150 IU were administered on alternate days from the 5th day onwards. Oocyte retrieval was carried out once at least two follicles of .18 mm were identified. The cycle was monitored by ultrasound only, with embryo transfer being carried out on Day 3. Clinical outcomes were recorded together with an estimation of the direct costs per cycle. Direct cost calculations did not include professional charges or facility costs.results: Of 143 women evaluated, 104 women underwent embryo transfer. The live birth rate and clinical pregnancy rate per embryo transfer were 19 and 22%. The live birth rate per initiated cycle was 14% (20/143). The multiple pregnancy rate was 26% with no case of ovarian hyperstimulation syndrome being recorded. The average direct cost per cycle was US$ 675 for IVF and US$ 725 for an ICSI treatment cycle.conclusions: Using this protocol, together with several cost cutting measures, we achieved an acceptable live birth rate per transfer of 19% at a reasonable cost. This approach could be used by established ART centres to provide treatment to couples who cannot afford conventional ART.

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Section: Discussionmentioning

confidence: 99%

Affordable ART: a different perspective

et al. 2011

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“…The use of a low-dose CC regimen in IVF is another option with reportedly acceptable results, minimal side effects and a very low complication rate (Steinkampf et al ., 1992; Massey et al ., 1994; Ingerslev et al ., 2001; Hovatta and Cooke, 2006). The use of CC-stimulation seems to be superior to natural or minimal stimulation IVF (Daya et al ., 1995; Ingerslev et al ., 2001; Nargund et al ., 2001).…”

Section: Suggested Strategies For Affordable Infertility Management Imentioning

confidence: 99%

“…Moreover, in the absence of social security systems, older people are economically completely dependent on their children. Childless women are frequently stigmatized, resulting in isolation, neglect, domestic violence and polygamy (Gerrits, 1997; Sundby, 1997; Papreen et al ., 2000; van Balen and Gerrits, 2001; Richards, 2002; van Balen, 2002; Araoye, 2003; Hollos, 2003; Wiersema et al ., 2006). …”

Section: Introductionmentioning

confidence: 99%

Infertility and the provision of infertility medical services in developing countries

Ombelet

Cooke²,

Dyer

et al. 2008

Human Reproduction Update

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530

398

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BACKGROUNDWorldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries.METHODSMedline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'.RESULTSThe exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes.CONCLUSIONSAlthough recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels.

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“…Considering laboratory procedures, it is possible to use a converted humidicrib-a plastic box commonly used for keeping newborns warm-instead of an expensive laminar flow hood [23]. With this method the handling of eggs and embryos can be done for a tenth of the price.…”

Section: Affordable Infertility Treatmentmentioning

confidence: 99%

Reproductive healthcare systems should include accessible infertility diagnosis and treatment: An important challenge for resource‐poor countries

Ombelet

2009

Intl J Gynecology & Obste

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Infertility is a central issue in the lives of many couples who suffer from it. In resource-poor countries the problem of childlessness is even more pronounced compared with Western societies owing to different sociocultural circumstances. It often leads to severe psychological, social, and economic suffering, and access to infertility treatment is often limited to certain procedures and certain costumers. The issue of infertility in resource-poor countries is underestimated and neglected, not only by local governments but also by the international nonprofit organizations. Simplification of the diagnostic and therapeutic procedures, minimizing the complication rate, and incorporating fertility centers into existing reproductive healthcare programs are essential measures to take in resource-poor countries if infertility treatment is to be accessible for a large part of the population. For reasons of social justice, a search for strategies to implement simplified methods of infertility diagnosis and treatment in resource-poor countries is urgently warranted.

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Cost‐effective approaches to in vitro fertilization: Means to improve access

Cited by 26 publications

References 30 publications

Affordable ART: a different perspective

Affordable ART: a different perspective

Infertility and the provision of infertility medical services in developing countries

Reproductive healthcare systems should include accessible infertility diagnosis and treatment: An important challenge for resource‐poor countries

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