scholarly journals Assisted reproduction in Spain, outcome and socioeconomic determinants of access

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ido Alon ◽  
Jaime Pinilla
Keyword(s):  
Assisted Reproductive Technologies ◽  
Research Question ◽  
Public Funding ◽  
Probit Model ◽  
Reproductive Technologies ◽  
Public Healthcare ◽  
Fertility Survey ◽  
Public Care ◽  
Socioeconomic Determinants ◽  
Public Clinics

Abstract Research question We analyzed two questions. First, the effectiveness of public Assisted Reproductive Technologies (ART) in Spain compared with private ones, measured by the time since initiating ART treatment until achieving pregnancy, accounting for age and socioeconomic factors. Second, socioeconomic determinants of access to ART, referring primarily to financial means derived by employment, income, and wealth. Design We applied statistical models on data extracted from the national Spanish Fertility Survey from 2018. The first topic was analyzed by competing risk survival analysis conducted on a sample of 667 women who initiate ART treatment since 2000. The second, by a Bivariate Probit model conducted on a sample of 672 women older than 41 years who required ART services. Results The first analysis raised that throughout the treatment, patients treated exclusively in private clinics had on average a higher cumulative incidence of becoming pregnant compared with patients who approached public clinics. The second analysis raised that both higher household equivalent income and higher education increase the likelihood of accessing ART in a private clinic and decrease the tendency of accessing public clinics or failing to access any service. Moreover, being single decreases the likelihood of accessing public clinics or ART services in general. Conclusions Long waiting periods could be the main reason for the lower incidence of getting pregnant in public healthcare, explaining why patients choose private over public care. We develop a broader discussion over the extent of Spanish public funding of ART, the unequal medical outcome, and potential options for optimization.

scholarly journals Assisted Reproduction in Spain, Outcome and Socioeconomic Determinants of Access

2021 ◽  
Author(s):  
Ido Alon ◽  
Jaime Pinilla Dominguez
Keyword(s):  
Assisted Reproductive Technologies ◽  
Research Question ◽  
Public Funding ◽  
Probit Model ◽  
Reproductive Technologies ◽  
Public Healthcare ◽  
Fertility Survey ◽  
Public Care ◽  
Socioeconomic Determinants ◽  
Public Clinics

Abstract Research Question: We analyzed two questions. First, the effectiveness of public Assisted Reproductive Technologies (ART) in Spain compared with private ones, measured by the time since initiating ART treatment until achieving pregnancy, accounting for age and socioeconomic factors. Second, socioeconomic determinants of access to ART, referring primarily to financial means derived by employment, income, and wealth. Design: We applied statistical models on data extracted from the national Spanish Fertility Survey from 2018. The first topic was analyzed by competing risk survival analysis conducted on a sample of 667 women who initiate ART treatment since 2000. The second, by a Bivariate Probit model conducted on a sample of 672 women older than 41 years who required ART services. Results: The first analysis raised that throughout the treatment, patients treated exclusively in private clinics had on average a higher cumulative incidence of becoming pregnant compared with patients who approached public clinics. The second analysis raised that both higher household equivalent income and higher education increase the likelihood of accessing ART in a private clinic and decrease the tendency of accessing public clinics or failing to access any service. Moreover, being single decreases the likelihood of accessing public clinics or ART services in general. Conclusions: Long waiting periods could be the main reason for the lower incidence of getting pregnant in public healthcare, explaining why patients choose private over public care. We develop a broader discussion over the extent of Spanish public funding of ART, the unequal medical outcome, and potential options for optimization.

scholarly journals Health status of children conceived by assisted reproductive technologies: endocrinologist’s position

2018 ◽  
Vol 64 (4) ◽  
pp. 235-243
Author(s):  
Zinaida S. Zyuzikova ◽  
Natalya N. Volevodz ◽  
Olga R. Grigoryan ◽  
Elena I. Degtyareva ◽  
Ivan I. Dedov
Keyword(s):  
Health Status ◽  
Assisted Reproductive Technologies ◽  
Public Funding ◽  
Endocrine System ◽  
Married Couples ◽  
Later Life ◽  
Reproductive Technologies ◽  
Male Population ◽  
Access To Treatment ◽  
Increased Risk

Assisted reproductive technologies (ART) are currently widely used around the world because of the increased prevalence of infertility (presently, about 15% of married couples suffer from infertility), as well as the increased access to treatment and public funding for this method. Hence, the number of children conceived by ART is steadily increasing every year. This review focuses on the pressing problem of the health status of children conceived by assisted reproductive technologies (ART) by analyzing modern publications on the state of physical, gonadal and psychosomatic development, features of the endocrine system and cardiometabolic diseases, the risk of imprinting changes, congenital malformations and oncological disorders. The data presented that there is no increased risk of childhood cancer or deterioration in quality of life. However, it is expected that the cardiovascular and metabolic risk factors found in childhood can worsen in later life and may ultimately be responsible for chronic cardiometabolic disease. Furthermore, the issue of fertility, especially in the male population conceived by ART, remains open, thus requiring additional longer-term research.

scholarly journals Endometrial Receptivity on Assisted Reproductive Technology Cycles – a correlation between Serial Serum Estradiol levels and Serial Endometrial Volume Assessment

2020 ◽  
Author(s):  
R. Silva Martins ◽  
A. Helio Oliani ◽  
D. Vaz Oliani ◽  
J. Martinez de Oliveira
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Research Question ◽  
Reproductive Technologies ◽  
Endometrial Receptivity ◽  
Serum Estradiol ◽  
Positive Group ◽  
Serial Serum ◽  
Endometrial Volume ◽  
Estradiol Levels

AbstractResearch QuestionDiagnosis of endometrial receptivity is still unclear and conflicting. Despite advances in embryo development during assisted reproductive technologies (ART) cycles, the intricate process of implantation is still matter for debate and research.DesignSerial serum estradiol levels and 3D transvaginal ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. 169 subjects on a prospective case control study were assessed. Serial biochemical and biophysical parameters were assessed during ovarian controlled stimulation and results compared in terms of pregnancy outcome.ResultsNo statistical difference was noted between the two groups in terms of demographics and ART procedures and scores. Serum estradiol was significantly higher in the positive group from day 8 after ovarian controlled stimulation. Endometrial volume and adjusted endometrial volume were significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation.ConclusionsContinuous serum estradiol and 3D endometrial volume and adjusted endometrial volumes may reflect endometrial changes during ART procedures and provide a useful real time tool for clinicians in predicting endometrial receptivity.

scholarly journals Situating Canada’s Commercial Surrogacy Ban in a Transnational Context: A Postcolonial Feminist Call for Legalization and Public Funding

2016 ◽  
Vol 61 (1) ◽  
pp. 31-86 ◽  
Author(s):  
Maneesha Deckha
Keyword(s):  
Assisted Reproductive Technologies ◽  
Public Funding ◽  
Reproductive Technologies ◽  
Feminist Perspective ◽  
Human Reproduction ◽  
Domestic Sphere ◽  
Commercial Surrogacy ◽  
Assisted Human Reproduction ◽  
Global North ◽  
Postcolonial Feminist

In large part due to feminist interventions in the early 1990s about the dangers of assisted reproductive technologies (ARTs) for women, Canada banned several practices related to ARTs when it enacted the Assisted Human Reproduction Act (AHRA) in 2004. Notably, the AHRA prohibited commercial surrogacy. Feminists feared that a market in surrogacy would exploit and objectify marginalized Canadian women who would be pressured into renting out their wombs to bear children for privileged couples. Since the early feminist deliberations that led to the ban, surrogacy has globalized. Canadians and other citizens of the Global North routinely travel to the Global South to source gestational surrogates. In doing so, they partake in an industry that heavily depends on material disparities and discursive ideologies of gender, class, and race. Indeed, the transnational nature of surrogacy treatment substantially reshapes the earlier feminist commodification debates informing the AHRA that took the domestic sphere as the presumed terrain of contestation. Due to the transnational North-South nature of surrogacy, a postcolonial feminist perspective should guide feminist input on whether to allow commercial surrogacy in Canada. I argue that when this framework is applied to the issue, the resulting analysis favours legalization of commercial surrogacy in Canada as well as public funding for domestic surrogacy services and ancillary ARTs.

Re-imagining Reproduction: Unsettling Metaphors in the History of Imperial Science and Commercial Surrogacy in India

Somatechnics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Kalindi Vora
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
The Body ◽  
Body Parts ◽  
Colonial History ◽  
Women's Bodies ◽  
Commercial Surrogacy ◽  
Art Practices ◽  
History Of ◽  
Travel Industry

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.

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