ArticleBMJ open2020
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 in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Perinatal outcomes and maternal health before and after single motherhood through assisted conception: A multiregistry study in Sweden.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Managing parental capacity concerns in IVF: the role of child welfare committees-a survey of unit directors.Journal of assisted reproduction and genetics · 2025Article
- Weight Stigma and Implicit Bias in Healthcare: Investigating the Impact of Women's Body Size on Continuity of Care and Communication About Sexual and Reproductive Health.Women's reproductive health (Philadelphia, Pa.) · 2025Article
- Relationship status among lesbian and heterosexual couples 8-10 years after undergoing assisted reproductive treatment in Sweden.Upsala journal of medical sciences · 2024Article
- The Challenge of Weight Stigma for Women in the Preconception Period: Workshop Recommendations for Action from the 5th European Conference on Preconception Health and Care.International journal of environmental research and public health · 2023Article
- Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes.Scientific reports · 2023Article
- General practitioners' perspectives of caring for larger-bodied preconception women: A descriptive qualitative study.Women's health (London, England)Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesStudy the proportion of patients affected by involuntary childlessness who are denied fertility treatment and the reasons behind this in a publicly funded healthcare system.
designSurvey study using prospectively collected information by healthcare professionals.
settingTwo university-affiliated fertility clinics in Sweden.
participantsSingle 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.
resultsThe 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.
conclusionBeing 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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