Journal of the European Society for Gynaecological Endoscopy


Ethical issues of infertility treatment in developing countries


Justice, low-cost IVF, overpopulation, prevention, QALY.

G. Pennings

Department of Philosophy and Moral Science, Bioethics Institute Ghent (BIG), Ghent University, Blandijnberg 2, 9000 Gent, Belgium.


The provision of infertility treatment in developing countries is controversial. Reports over the last decades have inculcated in people from Western countries the belief that overpopulation is the major problem of developing coun- tries. This paper will analyse the different arguments advanced for and against providing infertility treatment to resource-poor countries. There are two arguments in favour: reproductive autonomy and the huge burden of infer- tility in these countries. Pronatalism, which reigns in almost all developing countries, is to a great extent responsible for the devastating effects of infertility. The five arguments against the application of infertility treatment are over- population, prioritization of limited resources, prevention rather than cure, justice and equal access and risk of abuse. The importance of a person’s reproductive autonomy demands that efforts should be made to enable people to determine how many children to have. This is equally true in developing countries. However, given the enormous difficulties of resource-poor countries to provide even the most basic goods, the contribution by society should be directed mostly at prevention and should depend on a strong cost reduction for assisted reproductive technology.