RESUMO
BACKGROUND: The overall prevalence of infertility was estimated to be 3.5-16.7% in developing countries and 6.9-9.3% in developed countries. Furthermore, according to reports from some regions of sub-Saharan Africa, the prevalence rate is 30-40%. The consequences of infertility and how it affects the lives of women in poor-resource settings, particularly in developing countries, has become an important issue to be discussed in reproductive health. In some societies, the inability to fulfill the desire to have children makes life difficult for the infertile couple. In many regions, infertility is considered a tragedy that affects not only the infertile couple or woman, but the entire family. METHODS: This is a position paper which encompasses a review of the needs of low-income infertile couples, mainly those living in developing countries, regarding access to infertility care, including ART and initiatives to provide ART at low or affordable cost. Information was gathered from the databases MEDLINE, CENTRAL, POPLINE, EMBASE, LILACS, and ICTRP with the key words: infertility, low income, assisted reproductive technologies, affordable cost, low cost. RESULTS: There are few initiatives geared toward implementing ART procedures at low cost or at least at affordable cost in low-income populations. Nevertheless, from recent studies, possibilities have emerged for new low-cost initiatives that can help millions of couples to achieve the desire of having a biological child. CONCLUSIONS: It is necessary for healthcare professionals and policymakers to take into account these new initiatives in order to implement ART in resource-constrained settings.
Assuntos
Infertilidade Feminina/terapia , Infertilidade Masculina/terapia , Técnicas de Reprodução Assistida , Adulto , Países em Desenvolvimento , Características da Família , Feminino , Custos de Cuidados de Saúde , Política de Saúde , Recursos em Saúde/economia , Acessibilidade aos Serviços de Saúde/economia , Humanos , Infertilidade Feminina/economia , Infertilidade Masculina/economia , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Áreas de Pobreza , Técnicas de Reprodução Assistida/economiaAssuntos
Fertilização in vitro/economia , Fertilização in vitro/métodos , Gonadotropinas/antagonistas & inibidores , Gonadotropinas/uso terapêutico , Hormônio Foliculoestimulante/uso terapêutico , Indução da Ovulação/métodos , Redução de Custos/métodos , Fármacos para a Fertilidade Feminina/economia , Fármacos para a Fertilidade Feminina/uso terapêutico , Infertilidade Feminina/economia , Infertilidade Feminina/terapia , Fase LutealRESUMO
The prevalence of infertility has increased in recent years, but the medical services to treat these problems are not available for most of the affected couples. The prognosis for fertility is important in order to determine the therapeutic capacity of each service, and to select the couples that could be treated at a primary level, or to send them to more advanced levels of reproductive technology. In practice, the infertility is treated in primary medical levels and the assisted reproductive technology is available only to a limited sector of the poblation. In general, the managed-care plans do not compensate directly for infertility treatments, but they are indirectly paying some therapeutic procedures for fertility.