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  • Elenis, Evangelia,1983-Uppsala universitet,Uppsala University,Reproduktiv hälsa,Uppsala Univ, Sweden (author)

Access to infertility evaluation and treatment in two public fertility clinics and the reasons for withholding it : A prospective survey cohort study of healthcare professionals

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020-12-12
  • BMJ,2020

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  • LIBRIS-ID:oai:lup.lub.lu.se:cb4ec658-ca6f-45ba-869d-0a85985ca03c
  • https://lup.lub.lu.se/record/cb4ec658-ca6f-45ba-869d-0a85985ca03cURI
  • https://doi.org/10.1136/bmjopen-2020-041538DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-430583URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-172338URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

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  • Funding Agencies|FORTE, the Swedish Research Council for Health, Working Life and Welfare [2016-00583]; Uppsala University Hospital [ALF 1040530/2019]
  • Objectives Study the proportion of patients affected by involuntary childlessness who are denied fertility treatment and the reasons behind this in a publicly funded healthcare system. Design Survey study using prospectively collected information by healthcare professionals. Setting Two university-affiliated fertility clinics in Sweden. Participants Single women and couples in heterosexual and homosexual relationships seeking fertility evaluation and treatment between November 2017 and April 2018 (943 individual cases). Primary and secondary outcome measures Number and proportion of individuals who were either denied, delayed or granted fertility treatment directly. Furthermore, the reasons behind delaying or completely withholding treatment. Results The majority of those seeking evaluation were heterosexual couples (75%), while 14% were single women and 7.5% were same-sex couples. The great majority of those undergoing evaluation were granted treatment either directly (85%) or after in-depth evaluation (7.5%), while 7.5% were denied treatment. Among those who were denied treatment, there were a greater proportion of single women and couples seeking treatment with donated gametes. Among heterosexual couples, gamete origin was not associated with treatment refusal. Although age did not differ between those granted and denied treatment, a higher body mass index (in both recipient and partner, when applicable) was observed among those being refused treatment. Fertility specialists in Sweden focused their assessment on parental factors that may indirectly entail a risk of harm to the future child, such as medical and psychiatric conditions of the individuals involved, their financial constraints and other social reasons, substance abuse and female obesity. Conclusion Being single or receiving treatment with donated gametes can both be reasons for withholding fertility treatment. Although difficult to operationalise, parenting assessment in Sweden is employed interchangeably in treatments with donated gametes (legally mandated assessment) and even autologous gametes (non-legally mandated assessment) - making evident a need for clear official policy guidelines regulating these assessments and the provision of treatment.

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  • Skoog Svanberg, Agneta,1958-Uppsala universitet,Uppsala University,Reproduktiv hälsa,Uppsala Univ, Sweden(Swepub:uu)agssv172 (author)
  • Leandersson, PiaLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Dept Clin Sci Obstet & Gynecol, Lund, Sweden.(Swepub:lu)med-pje (author)
  • Lind, JudithLinköpings universitet,Linköping University,Linköping Univ, Dept Themat Studies Child Studies, Linköping, Sweden.,Tema Barn,Filosofiska fakulteten(Swepub:liu)judar16 (author)
  • Sydsjö, GunillaLinköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, Kvinnokliniken US(Swepub:liu)gunsy68 (author)
  • Uppsala UniversityReproduktiv hälsa (creator_code:org_t)

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  • In:BMJ Open: BMJ10:122044-6055

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Elenis, Evangeli ...
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Elenis, Evangelia,1983-
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