Objective: To determine the barriers of joining in-vitro fertilization (IVF) programs among infertile couples in developing countries.
Methods: This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed, ScienceDirect, EBSCO, ClinicalKey, and Cochrane Library from inception until December 31, 2021. Additional search strategies were snowballing literature search and citation tracking.
Results: Eleven articles were included in the scoping review. The cost was the greatest barrier of joining IVF program. Limited access and lack of assisted reproductive technology centers, few qualified infertility trained staff, insufficient government support, low priority in government policy, along with sociocultural factors, such as religion and false beliefs or myths were also majorly considered to be associated obstacles.
Conclusions: The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.
Conflict of interest statement
There are no conflicts of interest to be declared.
Funding
This study received no extramural funding.
Authors' contributions
Andriana K Dewi and Anggi L Wicaksana designed study and guided methodology. Andriana K Dewi and Muhammad Lutfi were responsible for searching, selection, data extraction and wrote the first draft. Andriana K Dewi, Anggi L Wicaksana and Agung Dewanto reviewed and discussed the manuscript. All authors approve and are responsible for publication.
Publisher' s Note
The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
| [1] |
Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology. Fertil Steril 2009; 92(5): 1520-1524.
|
| [2] |
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): 605-621.
|
| [3] |
Van Balen F, Gerrits T. Quality of infertility care in poor-resource areas and the introduction of new reproductive technologies. Hum Reprod 2001; 16: 215-219.
|
| [4] |
Ombelet W, Campo R. Affordable IVF for developing countries. Reprod Biomed Online 2007; 15(3): 257-265.
|
| [5] |
Hollos M, Larsen U, Obono O, Whitehouse B. The problem of infertility in high fertility populations: Meanings, consequences and coping mechanisms in two Nigerian communities. Soc Sci Med 2009; 68(11): 2061-2068.
|
| [6] |
Wiersema NJ, Drukker AJ, Dung MBT, Nhu GH, Nhu NT, Lambalk CB. Consequences of infertility in developing countries: Results of a questionnaire and interview survey in the South of Vietnam. J Transl Med 2006; 4: 54.
|
| [7] |
Adamson GD, Baker VL. Subfertility: Causes, treatment and outcome. Best Pract Res Clin Obstet Gynaecol 2003; 17(2): 169-185.
|
| [8] |
Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freundl G. Definition and prevalence of subfertility and infertility. Hum Reprod 2005; 20(5): 1144-1147.
|
| [9] |
Ombelet W. Reproductive healthcare systems should include accessible infertility diagnosis and treatment: An important challenge for resource-poor countries. Int J Gynecol Obstet 2009; 106(2): 168-171.
|
| [10] |
Nachtigall RD. International disparities in access to infertility services. Fertil Steril 2006; 85(4): 871-875.
|
| [11] |
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(6): 1506-1512.
|
| [12] |
Inhorn MC, Fakih MH. Arab Americans, African Americans, and infertility: Barriers to reproduction and medical care. Fertil Steril 2006; 85(4): 844-852.
|
| [13] |
Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018; 18(1): 143.
|
| [14] |
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018; 169(7): 467-473.
|
| [15] |
Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth 2020; 18(10): 2119-2126.
|
| [16] |
Akande SO, Dipeolu IO, Ajuwon AJ. Attitude and willingness of infertile persons towards the uptake of assisted reproductive technologies in Ibadan, Nigeria. Ann Ib Postgrad Med 2019; 17(1): 51-58.
|
| [17] |
Hiadzi RA, Woodward BJ. Infertility treatment decision-making in Ghana and contestations that may arise: A prospective sociological study. Glob Reprod Health 2019; 4(2): 32.
|
| [18] |
Khalifa DS, Ahmed MA. Reviewing infertility care in Sudan: Scultural, policy and ethical barriers. Facts Views Vis Obgyn 2012; 4(4): 53-58.
|
| [19] |
Murage A, Muteshi MC, Githae F. Assisted reproduction services provision in a developing country: time to act? Fertil Steril 2011; 96(4): 966-968.
|
| [20] |
Makuch MY, Bahamondes L. Barriers to access to infertility care and assisted reproductive technology within the public health sector in Brazil. Facts Views Vis Obgyn 2012; 4(4): 221-226.
|
| [21] |
Makuch MY, Simônia de Padua K, Petta CA, Duarte Osis MJ, Bahamondes L. Inequitable access to assisted reproductive technology for the low-income Brazilian population: A qualitative study. Hum Reprod 2011; 26(8): 2054-2060.
|
| [22] |
Bennett LR, Wiweko B, Hinting A, Adnyana IBP, Pangestu M. Indonesian infertility patients' health seeking behaviour and patterns of access to biomedical infertility care: An interviewer administered survey conducted in three clinics. Reproductive Health 2012; 9: 24.
|
| [23] |
Pashigian MJ. The growth of biomedical infertility services in Vietnam: Access and opportunities. Facts Views Vis Obgyn 2012; 4(4): 59-63.
|
| [24] |
Kulkarni G, Mohanty NC, Mohanty IR, Jadhav P, Boricha BG. Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic. J Hum Reprod Sci 2014; 7(4): 249-254.
|
| [25] |
Nahar P. Invisible women in Bangladesh: Stakeholders' views on infertility service. Facts Views Vis Obgyn 2012; 4(4): 30-37.
|
| [26] |
Tremayne S. The dilemma of assisted reproduction in Iran. Facts Views Vis Obgyn 2012; 4(4): 70-74.
|
| [27] |
Bennett LR. Infertility, womanhood and motherhood in contemporary Indonesia: Understanding gender discrimination in the realm of biomedical fertility care. Intersections 2012; 1(28): 1-12.
|
| [28] |
Serour GI, Serour AG. The impact of religion and culture on medically assisted reproduction in the Middle East and Europe. Reprod Biomed Online 2021; 43(3): 421-433.
|
| [29] |
Purvis TE. Assisted reproduction in Indonesia: Policy reform in an Islamic culture and developing nation. Reprod Biomed Online 2015; 31(5): 697-705.
|
| [30] |
Omokanye LO, Olatinwo AO, Salaudeen GA, Durowade KA, Panti AA, Balogun RO. Assisted reproduction technology in Nigeria: Challenges and the way forward. Afr J Infert Assist Concept 2018; 3: 2-5.
|
| [31] |
Hörbst V. “You need someone in a grand boubou” -barriers and means to access ARTs in West Africa. Facts Views Vis Obgyn 2012; 4(4): 46-52.
|
| [32] |
Harzif AK, Santawi VPA, Wijaya S. Discrepancy in perception of infertility and attitude towards treatment options: Indonesian urban and rural area. Reprod Health 2019; 16(1): 126.
|
| [33] |
Ekechi C. Addressing inequality in fertility treatment. Lancet 2021; 398(10301): 645-646.
|