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Accessibility to Reproductive Assistance in Low-Income Countries

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Abstract

In the past few years, the global health community has made a great effort to improve maternal and child health in low-income countries, in particular focusing on reproductive health.

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References

  1. Cui W. Mother or nothing: the agony of infertility. Bull World Health Organ. 2010;88:881–2. doi:10.2471/BLT.10.011210.

    Article  PubMed  Google Scholar 

  2. ESHRE Task Force on Ethics and Law. Providing infertility treatment in resource-poor countries. Hum Reprod. 2009;24(5):1008–11.

    Article  Google Scholar 

  3. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9(12):e1001356. doi:10.1371/journal.pmed.1001356.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22:1506–12. doi:10.1093/humrep/dem046.

    Article  PubMed  Google Scholar 

  5. Rutstein SO, Shah IH. Infecundity, infertility, and childlessness in developing countries. Calverton: ORC Macro; 2004. 57 p.

    Google Scholar 

  6. Sharma S, Mittal S, Aggarwal P. Management of infertility in low resource countries. BJOG. 2009;116 Suppl 1:77–83.

    Article  PubMed  Google Scholar 

  7. Cates W, Farley TMM, Row PJ. Worldwide patterns of infertility: is Africa different? Lancet. 1985;2:596–8.

    Article  CAS  PubMed  Google Scholar 

  8. World Health Organization. Infections, pregnancies and infertility: perspectives on prevention. Fertil Steril. 1987;47:944–9.

    Article  Google Scholar 

  9. Aboulghair MA. The importance of fertility treatment in the developing world. BJOG. 2005;112:1174–6.

    Article  Google Scholar 

  10. Ericksen K, Brunette T. Patterns and predictors of infertility among African women: a cross-national survey of twenty-seven nations. Soc Sci Med. 1996;42:209–20.

    Article  CAS  PubMed  Google Scholar 

  11. Sciarra JJ. Infertility: a global perspective. The role of pelvic infection. ORGYN. 1994;3:12–5.

    PubMed  Google Scholar 

  12. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update. 2008;14(6):605–21.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Adeniji RA, Olayemi O, Okunlola MA, Aimakhu CO. Pattern of semen analysis of male partners of infertile couples at the University College Hospital, Ibadan. West Afr J Med. 2003;22:243–5.

    CAS  PubMed  Google Scholar 

  14. Ikechebelu JI, Adinma JI, Orie EF, Ikegwuonu SO. High prevalence of male infertility in southeastern Nigeria. J Obstet Gynaecol. 2003;23:657–9.

    Article  CAS  PubMed  Google Scholar 

  15. Sciarra JJ. Sexually transmitted diseases: global importance. Int J Gynaecol Obstet. 1997;58:107–19.

    Article  CAS  PubMed  Google Scholar 

  16. Savasi V, Mandia L, Laoreti A, Cetin I. Reproductive assistance in HIV serodiscordant couples. Hum Reprod Update. 2013;19(2):136–50.

    Article  CAS  PubMed  Google Scholar 

  17. Gilling-Smith C, Nicopoullos JD, Semprini AE, Frodsham LC. HIV and reproductive care—a review of current practice. BJOG. 2006;113:869–78.

    Article  CAS  PubMed  Google Scholar 

  18. Nabaitu J, Bachengana C, Seeley J. Marital instability in a rural population in south-west Uganda: implications for the spread of HIV-1 infection. Africa (Lond). 1994;64:243–51.

    Article  CAS  Google Scholar 

  19. Parikh FR, Nadkarni SG, Kumat SA, Naik N, Soonawala SB, Parikh RM. Genital tuberculosis—a major pelvic factor causing infertility in Indian women. Fertil Steril. 1997;67:497–500.

    Article  CAS  PubMed  Google Scholar 

  20. Shaheen R, Subhan F, Tahir F. Epidemiology of genital tuberculosis in infertile population. J Pak Med Assoc. 2006;56:306–9.

    PubMed  Google Scholar 

  21. Sharma JB, Roy KK, Pushparaj M, Gupta N, Jain SK, Malhotra N, et al. Genital tuberculosis: an important cause of Asherman’s syndrome in India. Arch Gynecol Obstet. 2008;277:33–41.

    Google Scholar 

  22. Singh N, Sumana G, Mittal S. Genital tuberculosis: a leading cause of infertility in women seeking assisted conception in north India. Arch Gynecol Obstet. 2008;278:325–7.

    Article  PubMed  Google Scholar 

  23. Grimes DA, Benton J, Singh S, Romero M, Ganatra B, Okonofua FE, et al. Unsafe abortion: the preventable pandemic. Lancet. 2006;238:1908–19.

    Article  Google Scholar 

  24. Ganatra B, Tunçalp O, Johnston HB, Johnson Jr BR, Gülmezoglu AM, Temmerman M. From concept to measurement: operationalizing WHO’s definition of unsafe abortion. Bull World Health Organ. 2014;92:155. http://dx.doi.org/10.2471/BLT.14.136333.

    Article  PubMed  PubMed Central  Google Scholar 

  25. WHO. Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. 6th ed. Geneva: World Health Organization; 2011.

    Google Scholar 

  26. Stanton C, Blanc AK, Croft T, Choi Y. Skilled care at birth in the developing world: progress to date and strategies expanding coverage. J Biosoc Sci. 2007;39:109–20.

    Article  PubMed  Google Scholar 

  27. WHO. Female genital mutilation. Fact sheet No. 241. http://www.who.int/entity/mediacentre/factsheets/fs241/en/index.html (2014).

  28. Yoder PS, Khan S. Numbers of women circumcised in Africa: the production of a total. Calverton: Macro International; 2007.

    Google Scholar 

  29. Yoder PS, Abderrahim N, Zhuzhuni A. Female genital cutting in the Demographic and Health Surveys: a critical and comparative analysis. Calverton: Macro International; 2004.

    Google Scholar 

  30. Obermeyer CM. The consequences of female circumcision for health and sexuality: an update on the evidence. Cult Health Sex. 2005;7:443–61.

    Article  PubMed  Google Scholar 

  31. Dickens BM, Cook RJ. Reproductive health and public health ethics. Int J Gynaecol Obstet. 2007;99:75–9.

    Article  CAS  PubMed  Google Scholar 

  32. Bhutta ZA, Salam RA, Das JK. Meeting the challenges of micronutrient malnutrition in the developing world. Br Med Bull. 2013;106:7–17.

    Article  CAS  PubMed  Google Scholar 

  33. Cetin I, Berti C, Calabrese S. Role of micronutrients in the periconceptional period. Hum Reprod Update. 2010;16(1):80–95.

    Article  CAS  PubMed  Google Scholar 

  34. World Health Organization. World health report, 2000. Geneva: World Health Organization; 2000.

    Google Scholar 

  35. Smith K, Corvalán C, Kjellstrom T. How much global ill health is attributable to environmental factors? Epidemiology. 1999;10(5):573–84.

    Article  CAS  PubMed  Google Scholar 

  36. WHO. Environment and health in developing countries. http://www.who.int/heli/risks/ehindevcoun/en/. Accessed Sept 2014.

  37. Boivin J, Griffiths E, Venetis CA. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ. 2011;342:d223.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Fisher J, Hammarberg K. Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research. Asian J Androl. 2012;14:121–9.

    Article  CAS  PubMed  Google Scholar 

  39. Dhont N, Temmerman M, van de Wijgert J. Clinical, epidemiological and socio-cultural aspects of infertility in resource-poor settings. Evidence from Rwanda. Facts Views Vis Obgyn. 2011;3(2):77–88.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Dyer SJ, Abrahams N, Mokoena NE, van der Spuy ZM. “You are a man because you have children”: experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa. Hum Reprod. 2004;19:960–7.

    Article  CAS  PubMed  Google Scholar 

  41. Dyer SJ, Abrahams N, Mokoena NE, Lombard CJ, van der Spuy ZM. Psychological distress among women suffering from couple infertility in South Africa: a quantitative assessment. Hum Reprod. 2005;20:1938–43.

    Article  CAS  PubMed  Google Scholar 

  42. Wiersema NJ, Drukker AJ, Dung MBT, Nhu GH, Nhu NT, Lambalk B. Consequences of infertility in developing countries: results of a questionnaire and interview survey in the south of Vietnam. J Transl Med. 2006;4:54–61.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Araoye MO. Epidemiology of infertility: social problems of the infertile couples. West Afr J Med. 2003;22:190–6.

    PubMed  Google Scholar 

  44. Daar AS, Merali Z. Infertility and social suffering: the case of ART in developing countries. In: Vayena E, Rowe PJ, Griffin PD, editors. Current practices and controversies in assisted reproduction. Geneva: World Health Organization; 2002. p. 15–21.

    Google Scholar 

  45. Dyer S. The value of children in African countries—insights from studies on infertility. J Psychosom Obstet Gynaecol. 2007;28:69–77.

    Article  PubMed  Google Scholar 

  46. Fledderjohann JJ. ‘Zero is not good for me’: implications of infertility in Ghana. Hum Reprod. 2012;27:1383–90.

    Article  CAS  PubMed  Google Scholar 

  47. Obeisat S, Gharaibeh MK, Oweis A, Gharaibeh H. Adversities of being infertile: the experience of Jordanian women. Fertil Steril. 2012;98:444–9.

    Article  PubMed  Google Scholar 

  48. Papreen N, Sharma A, Sabin K, Begum L, Ahsan SK, Baqui AH. Living with infertility: experiences among urban slum populations in Bangladesh. Reprod Health Matters. 2000;8:33–44.

    Article  CAS  PubMed  Google Scholar 

  49. Van Balen F, Inhorn MC. Introduction interpreting infertility: a view from the social sciences. In: Inhorn MC, van Balen F, editors. Infertility around the globe: new thinking on childlessness, gender, reproductive technologies. Berkeley: University of California Press; 2002.

    Google Scholar 

  50. Hammarberg K, Kirkman M. Infertility in resource-constrained settings: moving towards amelioration. Reprod Biomed Online. 2013;26(2):189–95.

    Article  PubMed  Google Scholar 

  51. Schenker JG. Assisted reproductive practice: religious perspectives. Reprod Biomed Online. 2005;10(3):310–9.

    Article  PubMed  Google Scholar 

  52. Handwerker L. Social and ethical implications of in vitro fertilization in contemporary China. Camb Q Healthc Ethics. 1995;4:355–63.

    Article  CAS  PubMed  Google Scholar 

  53. Qiu RZ. Sociocultural dimensions of infertility and assisted reproduction in the Far East. In: Vayena E, Rowe PJ, Griffin PD, editors. Current practices and controversies in assisted reproduction. Geneva: World Health Organization; 2002. p. 75–8.

    Google Scholar 

  54. Macklin R. Reproductive technologies in developing countries. Bioethics. 1995;9:276–81.

    Article  PubMed  Google Scholar 

  55. Daar AS, Merali Z. Infertility and social suffering: the case of ART in developing countries. In: Vayena E, Rowe P, David Griffin P, editors. Current practices and controversies in assisted reproduction “medical, ethical and social aspects of assisted reproduction”. Geneva: WHO; 2004. p. 15–21.

    Google Scholar 

  56. Tangwa GB. ART and African sociocultural practices: worldview, belief and value systems with particular reference to francophone Africa. In: Vayena E, Rowe PJ, Griffin PD, editors. Current practices and controversies in assisted reproduction. Geneva: World Health Organization; 2002. p. 55–9.

    Google Scholar 

  57. WHO Department of Reproductive Health and Research. Accelerating progress towards the attainment of international reproductive health goals and framework for implementing the WHO global reproductive health strategy. Geneva: WHO Department of Reproductive Health and Research; 2006.

    Google Scholar 

  58. Indian Council of Medical Research. Need and feasibility of providing assisted technologies for infertility management in resource-poor settings. ICMR Bull. 2000;3:6–7. www.icmr.nic.in.

    Google Scholar 

  59. Gerrits T. Biomedical infertility care in low resource countries: barriers and access. Facts Views Vis OBGYN Monogr. 2012:1–6.

    Google Scholar 

  60. Inhorn MC. Global infertility and the globalization of new reproductive technologies: illustration from Egypt. Soc Sci Med. 2003;56:1837–51.

    Article  PubMed  Google Scholar 

  61. Ombelet W. Reproductive healthcare systems should include accessible infertility diagnosis and treatment: an important challenge for resource-poor countries. Int J Gynaecol Obstet. 2009;106:168–71.

    Article  PubMed  Google Scholar 

  62. Vayena E, Peterson HB, Adamson D, Nygren K. Assisted reproductive technologies in developing countries: are we caring yet? Fertil Steril. 2009;92:413–6.

    Article  PubMed  Google Scholar 

  63. Potts D, Marks S. Fertility in Southern Africa: the quiet revolution. J South Afr Stud. 2001;27:189–205.

    Article  CAS  PubMed  Google Scholar 

  64. United Nations General Assembly. The Universal Declaration of Human Rights (UDHR). www.un.org/en/documents/udhr/ (1948).

  65. United Nations International Conference on Population and Development, Cairo. www.un.org/popin/icpd2.htm (1994).

  66. Sallam H. Infertility in developing countries: funding the project. ESHRE Monogr. 2008;1:97–101.

    Article  Google Scholar 

  67. United Nations Millennium Development Goals. http://www.un.org/millenniumgoals.

  68. Fathalla MF, Sinding SW, Rosenfield A, Fathalla MM. Sexual and reproductive health for all: a call for action. Lancet. 2006;368:2095–100.

    Article  PubMed  Google Scholar 

  69. Vayena E, Rowe PJ, Griffin PD. Current practices and controversies in assisted reproduction. Report of a meeting. Geneva: World Health Organization; 2002.

    Google Scholar 

  70. ESHRE. http://www.eshre.eu/Specialty-groups/Task-Forces/Task-Force-Developing-Countries-and-Infertility.

  71. Ombelet W. Is global access to infertility care realistic? The Walking Egg Project. Reprod Biomed Online. 2014;28:267–72.

    Article  PubMed  Google Scholar 

  72. Ombelet W, van Balen F. Future perspectives. Facts Views Vis OBGYN Monogr. 2012:87–90.

    Google Scholar 

  73. Aleyamma TK, Kamath MS, Muthukumar K, Mangalaraj AM, George K. Affordable ART: a different perspective. Hum Reprod. 2011;26:3312–8.

    Article  CAS  PubMed  Google Scholar 

  74. Cooke ID, Gianaroli L, Hovatta O, Trounson A. Affordable ART in the Third World: difficulties to overcome. ESHRE Monogr. 2008;1:93–6.

    Article  Google Scholar 

  75. Hovatta O, Cooke ID. Cost-effective approaches to in vitro fertilization: means to improve access. Int J Gynaecol Obstet. 2006;94:287–92.

    Article  CAS  PubMed  Google Scholar 

  76. Ombelet W, Campo R. Affordable IVF for developing countries. Reprod Biomed Online. 2007;15:257–65.

    Article  PubMed  Google Scholar 

  77. Van Blerkom J, Ombelet W, Klerkx E, Janssen M, Dhont N, Nargund G, Campo R. First births with a simplified culture system for clinical IVF and ET. Reprod Biomed Online. 2013;28:310–20.

    Article  PubMed  Google Scholar 

  78. Chadwick RJ, Mantell JE, Moodley J, Harries J, Zweigenthal V, Cooper D. Safer conception interventions for HIV-affected couples: implications for resource-constrained settings. Top Antivir Med. 2011;19(4):148–55.

    PubMed  Google Scholar 

  79. Frodsham LC, Boag F, Barton S, Gilling-Smith C. Human immunodeficiency virus infection and fertility care in the United Kingdom: demand and supply. Fertil Steril. 2006;85(2):285–9.

    Article  PubMed  Google Scholar 

  80. Stanitis JA, Grow DR, Wiczyk H. Fertility services for human immunodeficiency virus-positive patients: provider policy, practice, and perspectives. Fertil Steril. 2008;89(5):1154–8.

    Article  PubMed  Google Scholar 

  81. WHO. HIV/AIDS. Fact sheet N°360. Updated Jul 2014; 2014.

    Google Scholar 

  82. Erhabor O, Akani CI, Eyindah CE. Reproductive health options among HIV-infected persons in the low-income Niger Delta of Nigeria. HIV AIDS. 2012;4:29–35.

    Google Scholar 

  83. Myer L, Carter RJ, Katyal M, Toro P, El-Sadr WM, Abrams EJ. Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study. PLoS Med. 2010;7(2):e1000229.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Mmeje O, van der Poel S, Workneh M, Njoroge B, Bukusi E, Cohen CR. Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya. AIDS Care. 2015;27(1):10–6. Epub 2014 Aug 8.

    Article  PubMed  Google Scholar 

  85. Matthews LT, Mukherjee JS. Strategies for harm reduction among HIV-affected couples who want to conceive. AIDS Behav. 2009;13 Suppl 1:5–11.

    Google Scholar 

  86. Walensky RP, Park JE, Wood R, Freedberg KA, Scott CA, Bekker LG, Losina E, Mayer KH, Seage III GR, Paltiel AD. The cost-effectiveness of pre-exposure prophylaxis for HIV infection in South African women. Clin Infect Dis. 2012;54(10):1504–13.

    Article  PubMed  PubMed Central  Google Scholar 

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Cetin, I., Laoreti, A. (2016). Accessibility to Reproductive Assistance in Low-Income Countries. In: Borini, A., Savasi, M. (eds) Assisted Reproductive Technologies and Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-30112-9_8

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