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Global Infertility

Experiences in Other Countries

By Debora Geary

For couples trying to address their infertility in the developing world, solutions are incredibly difficult. "Male infertility is often only treatable with ICSI (intracytoplasmic sperm injection, where a single sperm is injected directly into an egg), which is too high tech and too costly for most people in developing countries," says van Balen.

While there are some lower tech treatments for female infertility, often untreated STDs have resulted in tubal blockages, which means in vitro fertilization (IVF) is the only practical alternative. "IVF and ICSI are at present practically only in reach for the elite of these countries," says van Balen.

Even for those who can afford high tech fertility treatments and get access to a clinic, there are substantial hurdles. Like couples dealing with these treatments in North America, there are issues of variation in quality of treatment and success rates, but the lack of regulation in developing countries can make these challenges even more severe.

Cultural and religious factors may make some or all high-tech fertility treatments out of the question. For example, Inhorn says that some Islamic religious leaders prohibit any treatments that would involve a third-party donation, such as sperm or egg donation, or surrogacy. For many types of infertility, particularly several types of male factor infertility, the inability to use donated sperm rules out the possibility of successful infertility treatments.

Cultural and religious factors can also rule out one of the other solutions to infertility often embraced by North American couples: adoption. "Westerners view adoption as a 'natural' solution to infertility," says Inhorn. "[In the developing world], adoption is not available or acceptable in many societies. For example, the Qur'an (Koran) explicitly prohibits legal adoption, whereby a child adopts the surname of the adoptive parent. Islam gives legal precedence to purity of lineage and known parenthood of all children."

Want to see more?

• The Infertility Marketplace: How Success Rates Are Advertised
• Overcoming Infertility: A Compassionate Resource for Getting Pregnant
• Truth Be Told: Uncovering Common Infertility Myths
• Talk about it!