Tag: Fertility

Blog Posts (2)

June 15, 2014

Insurance Coverage for Oncofertility: Concerns about Socioeconomic Disparities

<p>In a recent <a href="/BioethicsBlog/post.cfm/the-importance-of-assisted-reproductive-technologies-for-women-in-developing-countries">blog</a>, I asserted that assisted reproductive technology (ART) should be a higher priority for the global South because of the severe health, social, and economic effects infertility can have on women there. The most common response to this claim is that resources should first be devoted to treating and preventing life-threatening conditions, such as malaria and HIV/AIDS, rather than conditions that are perceived as merely social and/or psychological. The same response is often used when people suggest that ART should receive higher priority in the global North. Whereas many global North countries provide national health coverage for ART, the US does not. However, there has been movement toward coverage for ART in the US in the last couple of decades and currently 14 states require health insurance companies to cover ART (though there is a wide range of what is covered and under what circumstances). Unfortunately, oncofertility (fertility preservation for cancer patients) is <a href="http://oncofertility.northwestern.edu/sites/default/files/uploadedfilecontent/basco_et_al._2010.pdf">not covered in any of these state laws</a>.</p> <p>While I understand the argument that limited healthcare resources should be dedicated to the most "pressing" conditions, it is also important to recognize the potential side effects of choosing not to provide coverage for oncofertility and other types of ART. One concern with the lack of coverage for ART is that it reinforces socioeconomic inequalities. The <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955265/">primary users of ART</a> are white, educated, middle- and upper-class not because this group is the most likely to be infertile, but because they are the most likely to be able to afford the high cost of ART out-of-pocket expenses. Cancer patients from lower socioeconomic backgrounds are unlikely to have the large amount of disposable funds (the <a href="http://www.asrm.org/detail.aspx?id=3023">average cost for one cycle of IVF</a> is around $12,400) for fertility preservation treatment. While “traditional” infertility patients can save their money over a period of time in order to be able to afford ART, cancer patients need to preserve their fertility before their cancer treatment commences and thus they need to be able to immediately provide the cash for fertility preservation treatment in order for it to occur. </p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
March 19, 2014

The importance of assisted reproductive technologies for women in “developing” countries

<p>While assisted reproductive technologies (ART) are common in most “developed” countries (the global North), in the global South (“developing” countries), ART is generally not available for a variety of reasons, most of which center around money. These resource-poor countries typically lack both qualified health-care professionals and facilities necessary for ART. Although some countries do have ART centers, the cost of ART is prohibitive for all but the extremely wealthy. Indeed, infertility is usually seen as a treatable problem only for the upper class primarily because the poor cannot afford basic health care let alone expensive treatment like ART. The fact that the majority of people in the global South cannot afford basic health care, which is typically seen as the top priority in health-care allocation, is another reason why ART are not readily available in the global South. Most public and private health-care funding goes toward primary care and not treatments that are often seen as elective and cosmetic, like ART.</p> <p>Yet, infertility can be considered a health problem according to the World Health Organization's broad definition of health – “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Infertility in the global South can have severe and interrelated social, economic, and health-related consequences for women. This is still the case when the woman is physiologically fertile but her partner has male factor infertility; she is the one who is generally blamed for the couple’s inability to have a biological child.</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>

Published Articles (2)

American Journal of Bioethics: Volume 10 Issue 11 - Nov 2010

Review of Charis Thompson, Making Parents: The Ontological Choreography of Reproductive Technologies

American Journal of Bioethics: Volume 3 Issue 1 - Mar 2003

Providing Fertility Care to Those With HIV: Time to Re-examine Healthcare Policy

News (2)

April 16, 2012 3:13 pm

IVF can't beat biological clock, warns Yale fertility expert (BioNews)

A leading fertility expert in the USA has warned of young women’s serious misconceptions about their own fertility. Writing in the journal Fertility and Sterility, Professor Pasquale Patrizio, from Yale School of Medicine and director of the Yale Fertility Centre, says that clinicians should ‘begin educating women more aggressively’ – but goes further. He argues that young women who choose to delay motherhood for whatever reason should be offered the opportunity to have their eggs frozen as an act of preventive medicine.

April 13, 2012 11:24 am

Fertility treatment bans in Europe draw criticism (Fox News)

More than three decades after Britain produced the world’s first test-tube baby, Europe is a patchwork of restrictions for people who need help having a child. Many countries have strict rules on who is allowed to get fertility treatments. And recent court rulings suggest nothing’s likely to change anytime soon.