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Assisted Reproduction in Developing Countries: The Debate at a Turning Point

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Reprogen-ethics and the future of gender

Part of the book series: International Library of Ethics, Law, and the New Medicine ((LIME,volume 43))

A recent report in the journal Nature described the story of a woman named Betty Chishava from Harare, Zimbabwe who was thrown out of her family home because she failed to conceive and refused to sleep with her brother in-law to increase her chances of getting pregnant [1]. She did not have access to treatment and in her culture she could not negotiate her status in her family and society outside motherhood. This is not a rare story rather the reality for many infertile women in developing countries. Infertility is not usually considered a developing world problem. Provision of infertility services and especially assisted reproduction are not on the resource allocation agenda. In the era of the HIV/AIDS epidemic, with malaria, tuberculosis and many other preventable or treatable diseases still claiming millions of lives, infertility can hardly make a case.

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References

  1. Pilcher H (2006) Fertility on a shoestring. Nature 442:975–977

    Google Scholar 

  2. Vayena E et al. (2002) Assisted reproductive technology in developing countries: why should we care? Fertil Steril 78:13–5

    Article  Google Scholar 

  3. Nachtigall RD (2006) International disparities in access to infertility services. Fertil Steril 85:871–5

    Article  Google Scholar 

  4. Rutstein S (2004) Infecundity, Infertility, and Childlessness in Developing Countries. DHS Comparative Reports No. 9. Calverton, Maryland, USA: ORC Marco and the World Health Organization

    Google Scholar 

  5. Schmidt L, Münster K (1995) Infertility, involuntary infecundity, and the seeking of medical advice in industrialized countries 1970–1992: A review of concepts, measurements and results. Hum Reprod 10:1407–18

    Google Scholar 

  6. Lunenfeld B, Van Steirteghem A (2004) Bertarelli Foundation. Infertility in the third millennium: implications for the individual, family and society: condensed meeting report from the Bertarelli Foundation’s second global conference. Hum Reprod Update 10:317–26

    Article  Google Scholar 

  7. Hamberger L, Janson PO (1997) Global importance of infertility and its treatment: role of fertility technologies. Int J Gynaecol Obstet 58:149–58

    Article  Google Scholar 

  8. Ibeh IN et al. (1994) Dietary exposure to aflatoxin in human male infertility in Benin City, Nigeria. Int J Fertil Menopausal Stud 39:208–14

    Google Scholar 

  9. Mattison DR et al. (1990) Reproductive toxicity: male and female reproductive systems as targets for chemical injury. Med Clin North Am 74:391–411

    Google Scholar 

  10. Turesky RJ et al. (2003) The effects of coffee on enzymes involved in metabolism of the dietary carcinogen 2-Amino-1-Methyl-6-Phenylimidazo[4,5-B]Pyridine in rats. Chem Biol Interact 145:251–65

    Article  Google Scholar 

  11. World Health Organization (2001) Global prevalence and incidence of selected curable sexually transmitted diseases: overview and estimates. Geneva: WHO

    Google Scholar 

  12. Inhorn M (2002) Global infertility and the globalization of new reproductive technologies: illustrations from Egypt. Soc Sci Med 56:1837–51

    Article  Google Scholar 

  13. Greil AL (1997) Infertility and psychological distress: a critical review of the literature. Soc Stud Med 45:1679–1704

    Article  Google Scholar 

  14. Hardy E, Makuch MY (2002) Gender, infertility and ART. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction- Report of a World Health Organization Meeting. Geneva: WHO

    Google Scholar 

  15. Van Balen F, Trimbos-Kemper TCM (1993) Long-term infertile couples, a study of their well-being. J Psychosom Obst Gynaecol 14:S53–S60

    Google Scholar 

  16. ESHRE Capri Workshop Group (2001) Social determinants of Human Reproduction. Hum Reprod 16:1518–26

    Google Scholar 

  17. Daar A, Merali Z (2002) Infertility and social suffering: the case of ART in developing countries. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction Report of World Health Organization Meeting. Geneva: WHO

    Google Scholar 

  18. Van Balen F, Gerrits T (2001) Quality of infertility care in poor-resource areas and the introduction of new reproductive technologies. Hum Reprod 16:215–9

    Article  Google Scholar 

  19. McCloskey LA et al. (2005) Gender inequality and intimate partner violence among women in Moshi, Tanzania. Int Fam Plan Perspect 31:124–30

    Article  Google Scholar 

  20. Widge A (2002) Sociocultural attitudes towards infertility and assisted reproduction in India. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction- Report of a World Health Organization Meeting. Geneva, WHO

    Google Scholar 

  21. Germain A (2004) Reproductive health and human rights. Lancet 363:65–6.

    Article  Google Scholar 

  22. Mukherjee M, Nadimipally S (2006) Assisted reproductive technologies in India. Development 49:128–34

    Article  Google Scholar 

  23. Heng BC (2006) The advent of international ‘mail-order’ egg donation. Br J Obstet Gynaecol 113:1225–7

    Google Scholar 

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

    Google Scholar 

  25. Okonofua FE (1996) The case against new reproductive technologies in developing countries. Br J Obstet Gynaecol 103:957–62

    Google Scholar 

  26. Macklin RB (1995) Reproductive technologies in developing countries. Bioethics 9:276–82

    Article  Google Scholar 

  27. Reproductive Health Outlook (2004) Infertility http://www.rho.org/html/files/RHO infert_12-19-04.pdf#search=“infertility” Accessed January 12 2008

  28. Vayena E, Rowe P, Griffin D (eds.) (2002) Current Practices and Controversies in Assisted Reproduction- Report of a World Health Organization meeting. Geneva: WHO

    Google Scholar 

  29. European Society for Human Reproduction (ESHRE). Task force for infertility in developing countries. http://www.eshre.com/emc.asp?pageId=1040 Accessed 20 January 2008

  30. Nargund G, Frydman R (2007) Towards a more physiological approach to IVF. Reprod Biomed Online 14(5):550–2

    Article  Google Scholar 

  31. Heitman E (1995) Infertility as a public health problem: why assisted reproductive technologies are not the answer. Stanford Law Pol Rev 6:89–102

    Google Scholar 

  32. Personal communication with Dr Karl Nygren, chair of the International Committee on Monitoring ART (ICMART) based on data from International Committee for Monitoring Assisted Reproductive Technology (ICMART) et al. (2006) World collaborative report on in vitro fertilization, 2000. Fertil Steril 85:1586–622

    Google Scholar 

  33. Liljestrand J, Pathmanathan I (2004) Reducing maternal mortality: can we derive policy guidance from developing country experiences? J Public Health Policy 25:299–314

    Article  Google Scholar 

  34. International Consumer Support for Infertility (2008) About international consumer support for infertility. http://www.icsi.ws/about_icsi Accessed January 30 2008

  35. Dill S (2002) Consumer perspectives. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction Report of World Health Organization Meeting. Geneva: WHO

    Google Scholar 

  36. United Nations Population and Development (1995) Programme of Action adopted at the International Conference on Population and Development: Cairo: 5–13 September 1994. New York: Department of Economic and Social Information and Policy Analysis, United Nations

    Google Scholar 

  37. Collins J (2002) An international survey of the health economics of IVF and ICSI. Human Reproduction Update 8:265–77 Oknofua FE (2003) New reproductive technologies and infertility treatment in Africa. Afr J Reprod Health 7:7–11

    Article  Google Scholar 

  38. Penning G (2007) Ethical issues in infertility in developing countries. http://www.eshre.com/file.asp?filetype=doc/04/014/001/001/7_s_arusha_infertility_2007.pdf Accessed 17 January 2008

  39. Aboulghar M (2005) The importance of fertility treatment in the developing world. Br J Obstet Gynaecol 112: 1174–6

    Google Scholar 

  40. World Health Organization (2004) Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets. http://www.who.int/reproductive-health/publications/strategy.pdf Accessed 12 January 2008

  41. Cook R, Dickens B, Fathalla M (2003) Reproductive health and human rights. New York: Oxford University Press

    Google Scholar 

  42. United Nations (1976) International Covenant on Economic, Social and Cultural Rights. http://www.unhchr.ch/html/menu3/b/a_cescr.htm Accessed January 30 2008

  43. United Nations (1948) Universal Declaration of Human Rights. http://www.un.org/Overview/rights.html Accessed January 30 2008

  44. FIGO Committee for the Study of Ethical Aspects of Human Reproduction and Women’s Health 2006) Ethical Issues in obstetrics and gynecology. http://www.figo.org/docs/Ethics%20Guidelines%20-%20English%20version%202006%20-2009.pdf Accessed 20 January 2008

  45. Chan CCW, Ho P-C (2006) Infertility, assisted reproduction and rights. Best Pract Res Clin Obstet Gynecol 20:369–80

    Article  Google Scholar 

  46. Chavkin W (2006) The old meets the new: Religion and assisted reproductive technologies. Development 49:78–83

    Article  Google Scholar 

  47. Luna F (2002) Assisted reproductive technology in Latin America: some ethical and sociocultural issues. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction- Report of a World Health Organization Meeting. Geneva: WHO

    Google Scholar 

  48. Zegers-Hochschild F (2002) The Latin American registry of assisted reproduction. In: Vayena E, Rowe P, Griffin D (eds.) Current Practices and Controversies in Assisted Reproduction- Report of a World Health Organization Meeting. Geneva: WHO

    Google Scholar 

  49. Bharadwaj A (2003) Why adoption is not an option in India: the visibility of infertility, the secrecy of donor insemination, and other cultural complexities. Soc Sci Med 56:1867–80

    Article  Google Scholar 

  50. Gerrits T (2000) Studying infertility and STD’s among the Macua in Montepuez, Mozambique: A multidisciplinary challenge. In: Van Balen F, Gerrits T, Inhorn MC (eds.) Proceedings of the conference on social science research on childlessness in a global perspective 8–11 November 1999, Amsterdam, The Netherlands. Amsterdam: SCO-Kohnstamm Instituut, University of Amsterdam

    Google Scholar 

  51. Pennings G, Ombelet W (2007) Coming soon to your clinic: patient-friendly ART. Human Reproduction 22:2075–9

    Article  Google Scholar 

  52. Hovatta O, Cooke I (2006) Cost-effective approaches to in vitro fertilization: means to improve access. Int J Gynaecol Obstet 94:287–91

    Article  Google Scholar 

  53. Gakidou E, Vayena E (2007) Use of Modern Contraception by the Poor is Falling Behind. Plos Medicine 4:381–9

    Article  Google Scholar 

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Vayena, E. (2009). Assisted Reproduction in Developing Countries: The Debate at a Turning Point. In: Simonstein, F. (eds) Reprogen-ethics and the future of gender. International Library of Ethics, Law, and the New Medicine, vol 43. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2475-6_6

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  • DOI: https://doi.org/10.1007/978-90-481-2475-6_6

  • Publisher Name: Springer, Dordrecht

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