The Impact of Access Barriers on Fertility Treatment Decision Making: A Qualitative Study From the Perspectives of Patients and Service Providers

Maxwell, Erika; Mathews, Maria; Mulay, Shree

doi:10.1016/j.jogc.2017.08.025

Cited by 5 publications

(18 citation statements)

References 14 publications

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“…The studies published ranged in date from 2009 to 2021. While many of the studies were published in the United States (11), studies were also based in Australia (3), Canada (2), Indonesia (1), Germany (1), and Ghana (1) [ 8 , 9 , 10 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…The studies investigated barriers to people either initiating or continuing infertility treatment or both. Fourteen of the studies focused on barriers to initiating ART, with barriers to continuing treatment being the focus of 4 studies [ 8 , 9 , 10 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. One study discussed both initiating and continuing fertility treatment [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…The general studies investigated reasons why a person or couple were less likely to initiate and/or continue ART, characterised demographic availability and utilisation, or considered reasons why people are less likely to initiate or continue ART. Eleven of the 19 studies were in this category [ 8 , 9 , 10 , 14 , 16 , 24 , 25 , 26 , 27 , 28 , 29 ]. The remaining eight studies investigated specific health determinants such as geographic location, a patient being of a racial or sexual minority, and/or socioeconomic status.…”

Section: Resultsmentioning

confidence: 99%

“…Barriers to accessing or continuing ART identified from each of the studies consisted of non-modifiable, social and economic, educational, and environmental determinants of health [ 31 ]. The most mentioned barrier was that of geographical location, which was highlighted in 11 of the 19 studies [ 8 , 9 , 10 , 15 , 16 , 19 , 20 , 24 , 27 , 28 , 29 ]. The second most common barrier appearing in half of the studies centred around the psychological barriers to initiating or continuing ART [ 8 , 9 , 14 , 18 , 20 , 24 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, there are other barriers that exist which prevent patients from initially accessing and/or continuing ART. As ART is a specialist medical service, facilities are generally only located in metropolitan and large regional areas, with greater populated cities providing more choice of service [ 7 , 8 , 9 , 10 ]. ART comprises complex treatments and stressful procedures, including daily self-administered injections, blood samples, ultrasound, and laparoscopic surgery, and involves a multidisciplinary team of medical specialists, midwives, registered nurses, laboratory staff, sonographers, administrative staff, psychologists, and pharmacists [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Inequity of Access: Scoping the Barriers to Assisted Reproductive Technologies

2023

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Infertility impacts millions of people of reproductive age worldwide, with approximately 10–15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility and include procedures such as in vitro fertilisation. This scoping review aims to explore the barriers to accessing assisted reproductive technologies to highlight a potential role for the pharmacist in addressing these barriers. Five databases, including CINAHL, Emcare, Medline, Scopus, and Web of Science, were searched using keywords that resulted in 19 studies that explored barriers to initially accessing or continuing ART. Studies identified more than one barrier to accessing ART, with the most mentioned barrier being the geographic location of the patient, with others themed as psychological, financial, minority groups, educational level, and the age of the patient. Recommendations were made to address barriers to accessing ART, which included changes to government regulations to increase health education and promotion of infertility. Pharmacists' accessibility, even in geographically remote locations, places them in an ideal position to address many of the challenges experienced by people accessing infertility treatment to improve outcomes for these people.

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