Evidence map›Paper›PMID 41174749›Full record

SynthesisReproductive health2025

Toward global reproductive justice: a universal framework for evaluating equity and autonomy in in-vitro fertilization policies.

Ruoran Murphy Qiu, Renee Muthakana, Wenhui Mao

Abstract readSystematic Review
In one paragraph

Synthesis in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

3 authors.

Ruoran Murphy Qiu *Duke Science & Society, Duke University, Durham, NC, 27710, USA.
Renee Muthakana *Duke Science & Society, Duke University, Durham, NC, 27710, USA.
Wenhui MaoDuke Global Health Institute, Duke University, Durham, NC, 27710, USA. wenhui.mao@duke.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEquitable and ethical access to in-vitro fertilization (IVF) remains challenging globally. Existing evaluation frameworks often overlook critical dimensions of reproductive justice. This study develops and validates a Universal IVF Justice Framework, designed to systematically evaluate national IVF policies regarding equity and reproductive autonomy.

methodsWe conducted a systematic literature review (PubMed, Scopus; January 1, 2010 to June 11, 2025) to identify key policy dimensions and indicators, followed by expert consultations and pilot testing to ensure reliability. The framework was validated through comprehensive document reviews and double-coding of IVF policies from 24 diverse countries. Visualization tools were created to illustrate outcomes.

resultsAnalysis revealed three overarching dimensions that shape national IVF policy outcomes: economic and structural conditions, cultural and social contexts, and healthcare system factors. Substantial variation emerged across countries. At the micro-level, country-specific analyses exposed targeted strengths and weaknesses, supporting localized reform efforts. Visualizations such as radar and scatter plots highlighted performance disparities. At the macro-level, high-income countries generally scored higher, driven by broader insurance coverage, inclusive legal protections, and greater geographic access. In contrast, low- and middle-income countries often faced challenges in affordability, rural service delivery, LGBTQ+ inclusivity, and psychosocial support.

conclusionsThe Universal IVF Justice Framework offers an empirically-grounded and ethically informed approach for evaluating IVF policies globally. By clearly identifying policy strengths and critical gaps, it supports evidence-based decision-making and targeted reforms aimed at enhancing equity and reproductive autonomy in IVF services worldwide.

Indexed as

Fertilization in VitroHealth EquityHealth PolicySocial JusticeFemaleGlobal HealthHealth Services AccessibilityHumansAutonomyEquityGlobal healthIVF policyPolicy evaluationReproductive justiceWomen’s health

Identifiers

PMID41174749
PMCPMC12577167

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.