Abstract

Background

In Brazil, access to infertility care, including assisted reproductive technologies (ARTs), is restricted. This is the third report of a study on access to infertility care and ARTs within the public sector, focusing on the barriers to these services.

Methods

The study was anchored on quantitative and qualitative methods. For the quantitative study interviews were conducted with health authorities in each of the 26 states, the Federal District, the state capitals and 16 cities with ≥ 500,000 inhabitants and directors of infertility referral centres within the public sector. Qualitative case studies were conducted in five ART centres.

Results

Overall, 63.5% of the authorities reported that complex infertility treatments were unavailable. Barriers identified consisted of “lack of political decision to implement them”, and “lack of financial resources”. In addition, 75% reported to have “no plans to implement them over the next 12 months”. At the facilities offering ART, the barriers to these procedures were the high costs, long waiting times, complex scheduling processes and lack of initiative to implement low cost ARTs.

Conclusions

Infertile couples’ access to ART procedures is restricted due to the insufficient services and lack of political commitment to support existing and new services.