Indicators of Infertility and Fertility Care: A Systematic Scoping Review
Abstract Background: The identification of appropriate, relevant and valid indicators of infertility and fertility care is critical to effective monitoring of progress in fertility care access, equity, utilization and impact globally. The aim of the review was to map existing literature on indicators of infertility and fertility care and summarize these indicators by typology and dimensions.Methods: This review followed the framework of Arksey and O’Malley. Bibliographic databases of published studies (MEDLINE, PubMed, JSTOR, CINAHL, Web of Science and Scopus) were searched from inception to June 2021. We also searched unpublished datasets and hand-searched reference lists of relevant articles. Two reviewers independently screened reports and extracted data onto a data charting table before collating and summarizing results.Results: We included 46 reports from 88 countries. The reporting of data was either voluntary in 63 countries (72%) and compulsory in 25 countries (28%). The reporting of data was partial in 63 countries (72%) and complete in 25 countries (28%). Reporting for cycles or deliveries were based on individual cycles in 56 countries (64%) and on cumulative cycles in 32 countries (36%). In types of overall typology, most of the indicators were outcome indicators (70%) with fewer being process indicators (16%) or structural indicators (14%). In terms of dimension, of most indicators were effectiveness and efficiency indicators. Indicators on safety, patient-centeredness, equity, and timeliness were under-reported.Conclusion: A wide range of indicators of infertility and fertility care exist in literature; however, most are outcomes indicators of effectiveness and efficiency dimensions, while those on safety, patient-centeredness, equity, and timeliness and non-clinical aspects are limited. These findings provide a basis for selection and prioritization of a core set of indicators to monitor progress in fertility care.Systematic review registration: Open Science Framework (osf.io/78wrg)