The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.
Restricted access to assisted reproductive technology and fertility preservation: legal and ethical issues
Abstract
Access to assisted reproductive technology (ART) and fertility preservation remains restricted in middle and low income countries. We sought to review the status of ART and fertility preservation in Brazil, considering social indicators and legislative issues that may hinder the universal access to these services. Although the Brazilian Constitution expressly provides the right to health, and ordinary law ensures the state is obliged to support family planning, access to services related to ART and fertility preservation is neither easy nor egalitarian in Brazil. Only a handful of public hospitals provide free ART, and their capacity far from meets demand. Health insurance does not cover ART, and the cost of private care is unaffordable to most people. Brazilian law supports, but does not command, the state provision of ART and fertility preservation to guarantee the right to family planning; therefore, the availability of state-funded treatments is still scarce, reinforcing social disparities. Economic projections suggest that including ART in the Brazilian health system is affordable and may actually become profitable to the state in the long term, not to mention the ethical imperative of recognizing infertility as a disease, with no reason to be excluded from a health system that claims to be 'universal'.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Accessibility and utilization are affected by physical features of clinics (e.g. access for the disabled, male services available only in female clinics), limitation of reproductive health information, and a regulatory environment that might restrict services and/or discriminate, e.g. LGBTQ+ or single people (ASRM The Ethics Committee, 2021; Oliveira et al., 2021).”
From Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature (2024) · cites this paper as Oliveira et al., 2021
Citations
Cites
The economic impact of assisted reproductive technology: a review of selected developed countries
Chambers, G. M., Sullivan, E. A., Ishihara, O., Chapman, M. G., & Adamson, G. D. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.04.029 · Cited by 438
Research works printed but not linked: 36
- ACOG, 2014, College of Obstetricians and Gynecologists Committee on Gynecologic Practice and The Practice Committee of the American Society for Reproductive Medicine, Fertility and Sterility, 101, 633
- Basco, 2010, Insuring against infertility: expanding state infertility mandates to include fertility preservation technology for cancer patients. The Journal of law, medicine & ethics: a journal of the American Society of Law, Medicine & Ethics, 38, 832
- Bourlon, 2020, Oncofertility as a Universal Right and a Global Oncology Priority, JCO Global Oncology, 6, 314, 10.1200/GO.19.00337 · DOI
- Busnelli, 2020, Fertility in female cancer survivors: a systematic review and meta-analysis, Reproductive biomedicine online, 41, 96, 10.1016/j.rbmo.2020.02.008 · DOI
- Carvalho, 2017, Ethical, moral and other aspects related to fertility preservation in cancer patients, JBRA Assisted Reproduction, 21, 45, 10.5935/1518-0557.20170011 · DOI
- Castro, 2019, Brazil's unified health system: the first 30 years and prospects for the future, Lancet (London, England), 394, 345, 10.1016/S0140-6736(19)31243-7 · DOI
- Cimadomo, 2018, Impact of Maternal Age on Oocyte and Embryo Competence, Frontiers in Endocrinology, 9, 10.3389/fendo.2018.00327 · DOI
- Connolly, 2010, The costs and consequences of assisted reproductive technology: an economic perspective, Human Reproduction Update, 16, 603, 10.1093/humupd/dmq013 · DOI · Paper page
- Connolly, 2021, Estimating the government public economic benefits attributed to investing in assisted reproductive technology: a South African case study, Reproductive Biomedicine Online, 12, 14, 10.1016/j.rbms.2020.08.001 · DOI · Paper page
- Correa, 2020, Reproductive technology and social justice: a view from Brazil, Reproductive Biomedicine Online, 41, 1151, 10.1016/j.rbmo.2020.11.003 · DOI
- De Neubourg, 2013, The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy, Human Reproduction, 28, 2709, 10.1093/humrep/det269 · DOI
- Fouks, Y., Hamilton, E., Cohen, Y., Hasson, J., Kalma, Y., Azem, F., 2020. In-vitro maturation of oocytes recovered during cryopreservation of pre-pubertal girls undergoing fertility preservation. Reproductive Biomedicine Online. · DOI
- Herndon, 2017, Outcomes from a university-based low-cost in vitro fertilization program providing access to care for a low-resource socioculturally diverse urban community, Fertility and Sterility, 108, 642, 10.1016/j.fertnstert.2017.06.035 · DOI
- IBGE, Instituto Brasileiro de Geografia e Estatística (2018). Estatísticas de Gênero: Indicadores sociais das mulheres no Brasil, pp. 1-13.
- Inhorn, 2015, Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century, Human Reproduction Update, 21, 411, 10.1093/humupd/dmv016 · DOI · Paper page
- Jain, 2019, 30 years of data: impact of the United States in vitro fertilization data registry on advancing fertility care, Fertility and Sterility, 111, 477, 10.1016/j.fertnstert.2018.11.015 · DOI
- Katabi, 2020, Ethical Considerations of Fertility Preservation for Transmasculine and Nonbinary Youth, Transgender Health, 5, 201, 10.1089/trgh.2020.0004 · DOI
- Kenny, 2008, An ethical analysis of international health priority-setting. Health care analysis: HCA, Journal of Health Philosophy and Policy, 16, 145
- Leite, 2019, [Critical analysis on the evolution of ethical norms for the use of assisted reproduction techniques in Brazil], Ciencia & Saúde Coletiva, 24, 917, 10.1590/1413-81232018243.30522016 · DOI
- Makuch, 2011, Inequitable access to assisted reproductive technology for the low-income Brazilian population: a qualitative study, Human Reproduction, 26, 2054, 10.1093/humrep/der158 · DOI
- Mayhew, 2020, Fertility Options for the Transgender and Gender Nonbinary Patient, Journal of Clinical Endocrinology and Metabolism, 105, 3335, 10.1210/clinem/dgaa529 · DOI
- Monteiro, 2019, Uterine alterations in women undergoing routine hysteroscopy before in vitro fertilization: high prevalence of unsuspected lesions, JBRA Assisted Reproduction, 23, 396
- Moraes, 2019, Oocyte cryopreservation for future fertility: comparison of ovarian response between cancer and non-cancer patients, JBRA Assisted Reproduction, 23, 91
- Nasab, 2020, Elective egg freezing: what is the vision of women around the globe?, Future Science OA, 6, Fso468, 10.2144/fsoa-2019-0068 · DOI
- Ombelet, 2005, Multiple gestation and infertility treatment: registration, reflection and reaction–the Belgian project, Human Reproduction Update, 11, 3, 10.1093/humupd/dmh048 · DOI
- Rashedi, 2018, Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe, Journal of global oncology, 4, 1
- Roque, 2015, Cost-Effectiveness of the Freeze-All Policy, JBRA Assisted Reproduction, 19, 125, 10.5935/1518-0557.20150028 · DOI
- Salama, 2018, Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama, Journal of Global Oncology, 4, 1
- Salama, 2020, Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic, Journal of Assisted Reproduction and Genetics, 37, 1567, 10.1007/s10815-020-01821-7 · DOI
- Santo, 2017, Social oocyte cryopreservation: a portrayal of Brazilian women, JBRA Assisted Reproduction, 21, 101, 10.5935/1518-0557.20170024 · DOI
- Sharma, 2013, Lifestyle factors and reproductive health: taking control of your fertility, Reproductive Biology and Endocrinology, 11, 66, 10.1186/1477-7827-11-66 · DOI
- Silva, 2019, Assisted reproductive technology: prevalence and associated factors in Southern Brazil, Revista de Saude Pubúlica, 53, 13, 10.11606/S1518-8787.2019053000737 · DOI
- Sun, 2019, Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: results from a global burden of disease study, 2017, Aging, 11, 10952, 10.18632/aging.102497 · DOI
- United Nations (2014).Programme of Action of the International Conference on Population Development UNFPA, New York.
- Woodruff, 2015, Oncofertility: a grand collaboration between reproductive medicine and oncology, Reproduction, 150, S1, 10.1530/REP-15-0163 · DOI
- Zegers-Hochschild, 2020, Assisted reproductive techniques in Latin America: The Latin American Registry, 2017, JBRA Assisted Reproduction, 24, 362
Cited by
Fauser, B. C. J. M., Adamson, G. D., Boivin, J., Chambers, G. M., de Geyter, C., Dyer, S., Inhorn, M. C., Schmidt, L., Serour, G. I., Tarlatzis, B., et al. (2024) · Human Reproduction Update · doi:10.1093/humupd/dmad028 · Cited by 224
“…(e.g. access for the disabled, male services available only in female clinics), limitation of reproductive health information, and a regulatory environment that might restrict services and/or discriminate, e.g. LGBTQ þ or single people (ASRM The Ethics Committee, 2021; Oliveira et al. , 2021).”
BackgroundGao, Y., Wang, X., Wang, Q., Jiang, L., Wu, C., Guo, Y., Cui, N., Tang, H., & Tang, L. (2025) · Reproductive Health · doi:10.1186/s12978-025-02013-1 · Cited by 35
Supplementation with NAD+ and its precursors: A rescue of female reproductive diseases
Li, L., Zhou, X., Liu, W., Chen, Z., Xiao, X., & Deng, G. (2024) · Biochemistry and Biophysics Reports · doi:10.1016/j.bbrep.2024.101715 · Cited by 9
“Currently, hormone replacement therapy (HRT) and assisted reproductive technology (ART) are mainly used to improve the pregnancy rate of women, but both have limitations [2,3].”
BackgroundSerafin, D., Grabarek, B., Boroń, D., Madej, A., Cnota, W., & Czuba, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19084914 · Cited by 10
Ebrahimi, V., Abdolmohammadi‐Vahid, S., Soltani‐Zangbar, M. S., Ahmadi, H., & Maleki, L. A. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2025.118889 · Cited by 8
Metadata
- Authors
- Oliveira, B. L., Ataman, L. M., Rodrigues, J. K., Birchal, T. S., & Reis, F. M.
- Affiliations
- Northwestern University (US)
- Universidade Federal de Minas Gerais (BR)
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 43
- Issue
- 3
- Pages
- 571-576
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W3177137588
- Cited by
- 14
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 1
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Social Sciences › Law › Medical and Health Sciences Research
- Social Sciences › Political Science and International Relations › International Human Rights and Reproductive Law
- Keywords
- assisted reproduction, fertility preservation, access to reproductive health services, right to health, family planning, health insurance coverage, health care inequities, public health funding, Brazil, reproductive ethics, reproductive law
- MeSH terms
- Brazil, Family Planning Services, Female, Health Services Accessibility, Humans, Infant, Newborn, Infertility, Male, Pregnancy, Reproductive Techniques, Assisted, Reproductive Rights, Healthcare Disparities, Fertility Preservation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Restricted access to assisted reproductive technology and fertility preservation: legal and ethical issues. https://app.cochat.ai/papers/10.1016/j.rbmo.2021.06.018
- The paper
- Oliveira, B. L., Ataman, L. M., Rodrigues, J. K., Birchal, T. S., & Reis, F. M. (2021). Restricted access to assisted reproductive technology and fertility preservation: legal and ethical issues. Reproductive BioMedicine Online. https://doi.org/10.1016/j.rbmo.2021.06.018
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.