Access to Infertility Services in Middle East

In the new millennium, health promotion and reducing mortality from infectious diseases in developing and developed countries necessitates more focus to other various aspects of human health, such as sexual and reproductive health. Over the past two decades, more attention has been paid to the prevention of infertility and providing equitable access to effective and safe infertility treatment technologies at global scale. Despite the efforts of international organizations, governments, regional institutions and non-governmental organization, currently about 25 percent of infertile couples have access to infertility treatment in developed and developing countries. However, the condition in South of Africa is much worse that in some countries only one or two centers in the capital provide minimal services of infertility treatment (1). Assessment of infertility treatments in different countries shows that development of IVF clinic in Middle East region is faster than the rest of the world and even more than European and North American countries. The first centers in this region were established a few years after the ones in European countries. For example, more than 70 centers are active in Iran that more than 25 centers of them are in capital or more than 110 centers are active in Turkey and also Emirates, Egypt, Jordan, and Saudi Arabia have the same situation. The development of infertility treatment and increased numbers of IVF centers in this region depend on numerous factors. The most important factors are governmental support, partial or full insurance coverage of treatment cost, social and religious values of childbearing and the role of children in family stability. The increase in number of IVF clinics in private and governmental sections was a positive competition and increased the quantity and quality of treatment services in these countries. Another benefit of this development was the decrease in cost of infertility treatment services in Middle East region. So that the cost of one cycle of assisted reproductive technology (ART) treatment on average is less than 2000 dollars (about 1000 dollars for diagnostic and imaging tests, drugs and stimulation protocols and about 1000 dollars for operation, ovum pickup, fertilization, embryo culture and transfer and also cryopreservation of extra embryos) in Iran compared to more than 20000 dollars in UK and United States. Although this cost may be relatively high for people compared to annual income of people in these countries, accessibility to infertility service is easier and more convenient in the Middle East. As a result, quick and easy access of people to health services, as well as infertility treatment as one of the development goals of world health organization is somewhat available in this region (2). Iran is typically considered a developing country. Iran's population increased dramatically during the latter half of the 20th century. Recently, however, Iran's birth rate has significantly declined. But Iran's rate of population growth will continue gradually to stabilize above 90 million in 2050. Presently, more than half of the people are under the age of 24, one quarter being 15 years of age or younger (3). Therefore, the need for reproductive health service and infertility treatment will increase in future. The number of IVF clinics will be doubled very soon in future years to provide infertility services for young population. Alongside providing infertility services to Iranian couples due to great comparative advantage of Iran compared to other Middle East countries on low cost of traveling, hotels, transportation, living, infertility treatment and diversity of health services (ART, PGD, third-party reproduction, donor services), Iran is a good destination for health tourism of infertile couples. In fact, recently, infertile couples form neighboring countries especially Iraq and Afghanistan received their treatment from Iranian centers; regarding recent changes in the world policy to engage with Iran, Iran will be the host of foreign infertile couples specially Muslims to receive infertility treatment services in near future.