Evidence map›Paper›PMID 39946323›Full record

ArticlePloS one2025

Financial cost of assisted reproductive technology for patients in high-income countries: A systematic review protocol.

Purity Njagi, Wim Groot, Jelena Arsenijevic, Gitau Mburu, Georgina Chambers, Carlos Calhaz-Jorge, James Kiarie

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Purity NjagiUNU-Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht University, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0003-3157-4413
Wim GrootUNU-Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht University, Maastricht, The Netherlands.
Jelena ArsenijevicSchool of Governance, Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands.
Gitau MburuDepartment of Sexual and Reproductive Health and Research, World Health Organization, Genève, Switzerland.
Georgina ChambersNational Perinatal Epidemiology and Statistics Unit (NPESU), Centre for Big Data Research in Health and School of Clinical Medicine, University of New South Wales (UNSW), Sydney, Australia.
Carlos Calhaz-JorgeClinic of Obstetrics and Gynaecology, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
James KiarieDepartment of Sexual and Reproductive Health and Research, World Health Organization, Genève, Switzerland.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundInfertility affects one in six people globally, with similar prevalence rates across high-income and low- and middle-income countries. Technological advancements, particularly in Assisted Reproductive Technology (ART), have improved fertility treatment options. Although access to ART is presumed to be better in high-income countries (HICs), economic factors and eligibility restrictions could still impact effective utilization in these settings. Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA-P), this protocol outlines the methodological and analytical approaches to examine the ART costs paid by patients in HICs and the correlation with economic indicators and ART regulatory frameworks.

methodsFollowing the PRISMA approach, we will search for articles indexed in PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, PsycINFO, and Latin American & Caribbean Health Sciences Literature (LILACS). Grey literature from relevant organizations' virtual databases will also be searched. The review will encompass studies published between 2001 and 2024, with the primary outcome being ART direct medical and direct non-medical costs, while secondary outcomes shall include ART financing arrangements. The review will synthesize ART costs, adjusting them to USD Purchasing Power Parity for cross-country comparison, and correlate findings with GNI per capita and ART financing policies. The Integrated Quality Criteria for Review of Multiple Study Designs (ICROMS) tool will be utilized to evaluate the quality of the included studies. We will conduct a meta-analysis if the studies provide sufficient cost-effect size estimates. DISCUSSION: The review findings will contribute to our understanding of the potential financial burden faced by (disadvantaged) individuals in HICs due to ART costs. Additionally, the review shall highlight the implications that ART financing policies have in enhancing access and affordability, offering valuable insights for healthcare planning and policy formulation. The results will be disseminated through a peer-reviewed journal article and relevant international conferences.

trial registrationSystematic review registration: PROSPERO number: CRD42023487655.

Indexed as

Developed CountriesInfertilityReproductive Techniques, AssistedHumansSystematic Reviews as Topic

Identifiers

PMID39946323
PMCPMC11825044

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.