Future Perspectives


Affordable, developing countries, ethics, infertility, IUI, IVF, low cost ART, politics, reproductive care, simplified methods, socio-cultural.

W. Ombelet1, F. Van Balen2

1Genk Institute for Fertility Technology, Department of Obstetrics and Gynaecology, Schiepse Bos 6, 3600 Genk, Belgium, Coordinator of the Special Task Force on ‘Developing countries and infertility’of the European Society of Human Reproduction and Embryology (ESHRE).

2Associated professor Emeritus. Faculty of Social and Behavioural Sciences, Department of Education, University of Amsterdam, the Netherlands.


According to WHO data more than 180 million couples are confronted with the consequences of childlessness day by day. The consequences of involuntary childlessness are much more dramatic in developing countries, particularly for women. The most important reason for childlessness in developing countries is severe male infertility due to sexually transmitted diseases (STDs) and female infertility due to blocked tubes. Both problems can only be treated by “expensive” assisted reproductive technologies (ART) which are not available at all or only within reach of those who can afford it, mostly in a private setting.

Numerous barriers against infertility care provision in resource-poor countries are reported in this Monograph. It is clear that we need a global approach to reach the ultimate goal: the implementation of accessible infertility care services all over the world. Keystones for success include simplification of diagnostic procedures and ART methods, minimising the complication rate of interventions, providing training-courses for health care workers, paying attention to the psychosocial aspects of patients and the cultural settings. In this it is utmost important to incorporate infertility treatment into existing reproductive health care programmes. The Walking Egg Project aims to start with the implementation of low-cost “accessible” infertility services in developing countries, integrated within health care clinics dealing with good quality family planning, health education, maternity- and child care facilities.

The project needs the support of a strong network of social scientists doing research in the field of infertility, childlessness and assisted reproductive technologies in poor resource settings. This network can help the project in the preparation and follow-up of the pilot-centres including monitoring and assessment of the social, psychological, cultural, ethical and juridical aspects.