Challenges – Addressing subfertility/infertility in developing countries
“Limited information is available pertaining to the ways biomedical infertility care is supplied and used in different developing countries and within low resource contexts, though the number of studies in this area has increased over the last decade.“ Bringing “together insights from various local realities is required in order to increase understanding of factors and circumstances that are constraining, complicating and/or facilitating the provision and use of infertility services in different contexts.”
An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment. Opinion papers submitted by all participants will prioritize and address adaptation issues surrounding key questions which contribute to the consultations generating evidence-based WHO Guidelines.
Developing country perspective
CRITICISM: “Infertility in developing countries raises distinct and complex problems beyond those well known to developed nations. The effects of infertility and the concomitant need for its health care management relate to the cultural realities of specific regions. While the relevance and need for assisted reproduction may be readily established, some challenge their use in developing nations. This criticism is leveled on two grounds: First, given the overpopulation problem in many developing countries, it is argued that over fertility, rather than infertility, should be the focus of family planning programmes; and, Second, treating infertility through expensive treatments cannot be justified in low resource settings where other more pressing needs must be given priority.”
RESPONSE: “From an analysis of the suffering that arise from infertility, those criticisms of the use of {new, innovative technologies} can be rebutted. Infertility in developing countries is pervasive and a serious concern. Further, there is evidence that the infertility rates that are generally quoted are, in fact, underestimates. The consequences of infertility in developing countries range from severe economic deprivation, to social isolation, to murder and suicide. It is suggested that the overpopulation and limited resource arguments falsely target assisted reproduction and lack a more comprehensive understanding of the public health, social, psychological, economic, political and moral issues that are involved.” Daar and Merali, from “Current practices and controversies in Assisted Reproduction, Report of a WHO Meeting” 2002.
Meet the Experts
Steering Committee: Clinical Global Guidelines Development & Research Gaps: Paul Devroey (Belgium), Bart Fauser (the Netherlands), Felice Petraglia (Italy), Roger Lobo (USA), Basil Tarlatzis (Greece), David Adamson (USA)
Steering Committee: Country Assessment and Building Capacity
Female subfertility work-up, Chair: Hans Evers (the Netherlands); Members: Neil Johnson (New Zealand), Guo Sun-Wei (China), Ben Willem Mol (Netherlands), Ed Hughes (Canada), Robert Rebar (USA), Johnny Awwad (Lebanon)
Male subfertility work-up, Chair: Christopher Barratt (UK); Members: Herman Tournaye (Belgium), Rob McLachlan (Australia), Christopher De Jonge (USA), Lars Björndahl (Sweden), Bob Oates (USA)
Ovarian stimulation for ART, Chair: Anders Nyboe Andersen (Denmark); Members: Georg Griesinger (Germany), Basil Tarlatzis (Greece) , Alan Penzias (USA), Frank Broekmans (Netherlands)
IVF, ICSI, Chair: André van Steirteghem (Belgium); Members: John Collins (Canada), Arne Sunde (Norway), Laura Francesca Rienzi (Italy), Catherine Racowsky (USA), Andy LaBarbera (USA)
IUI with or without ovarian stimulation, Chair: Willem Ombelet (Belgium); Members: Ben Cohlen (the Netherlands), Geeta Nargund UK), Carin Huyser (South Africa), Aucky Hinting (Indonesia)
PCOS, Chair: Adam Balen (UK) , Steve Franks (UK), Rick Legro (USA), Rob Norman (Australia), Chandrika Wijeyeratne (Sri Lanka)
- GFMER Global Consultation on WHO Infertility Guidelines: Expert Working Groups (EWG)
- Back to fertility and infertility HOME PAGE
* Geneva Foundation for Medical Education and Research (GFMER)