Research and innovation
There's a need for research on social, cultural, ethical, religious and juridical aspects of infertility in poor-resource countries. What are pathways to healthcare and treatment access? What are the financial and economical consequences of infertility treatment compared to the actual situation? We also aim to initiate and expand an international network of social science research (in broad sense) in these fields.
In order to make fertility care more affordable in developing countries, effective, cheap and safe stimulation schemes for intrauterine insemination (IUI) and in-vitro fertilization (IVF) need to be established. A review of the literature and feasibility studies have to be performed to examine the value of these protocols in resource-poor settings. A major challenge is to reduce costs of laboratory procedures, namely fertilization and culture of eggs and embryos. Different options and approaches have been developed or are presently being field-tested with very promising results.
The countries where the first pilot centers will be implemented, will be selected based on available data on the resources, needs and resource gaps for fertility services on a national level. Once a pilot-centre is started, it must be an objective to register all data at the start, if possible ‘online’.
Advocacy and networking
Global access to fertility care can only be implemented and sustained if it is supported by local policy makers and the international community. Many international organizations have already expressed their desire to collaborate including WHO, ESHRE and ISMAAR (International Society for Mild Approaches to Assisted Reproduction). We will also need to the media, patient organizations and interested politicians to change the existing moral and socio-cultural beliefs that are isolating and ostracizing infertile couples.
Training and capacity building
Health professionals should receive regular training courses on the diagnosis and prevention of infertility in developing countries, endoscopic surgery, the clinical aspects of IUI and IVF and the laboratory aspects of IVF/ICSI. Training, quality control, regular audit and systems of accreditation and registration should be implemented in order to maintain appropriate standards of care.
The ultimate aim is to establish low-cost fertility services in developing countries. Diagnostic and therapeutic procedures and protocols should be affordable, effective, safe and standardized. Ideally, infertility management should be integrated into sexual and reproductive health care programmes. Once all preconditions are met, an infertility programme can be up and running in any country within a reasonable number of months.