Stigma around in vitro fertilisation in Pakistan
Authors: Momina Khabir, Asharib Sohaib, Marium Fawad
Journal: The Lancet (2024)

With the advent of in vitro fertilisation (IVF), assisted reproductive medicine has been revolutionised, offering hope to countless individuals struggling with infertility globally.1Rehman Medical InstituteUnderstanding infertility: overcoming hurdles, embracing hope. Rehman Medical Institute, Aug 3, 2023https://rmi.edu.pk/blogs/understanding-infertility-overcoming-hurdles-embracing-hope-0Date accessed: March 15, 2024Google Scholar Despite a high infertility rate of 21% in Pakistan's large population of approximately 242·8 million people, access to IVF remains low.1Rehman Medical InstituteUnderstanding infertility: overcoming hurdles, embracing hope. Rehman Medical Institute, Aug 3, 2023https://rmi.edu.pk/blogs/understanding-infertility-overcoming-hurdles-embracing-hope-0Date accessed: March 15, 2024Google Scholar Infertility carries a heavy social stigma, particularly for women. This stigma, coupled with rising poverty (over 39% of the population lives below the poverty line), discourages couples from seeking IVF.2The Times of IndiaNearly 40% of Pakistan's population now living below poverty line. World Bank, Sept 24, 2023https://timesofindia.indiatimes.com/world/pakistan/nearly-40-of-pakistans-population-now-living-below-poverty-line-world-bank/articleshow/103886595.cmsDate accessed: March 16, 2024Google Scholar Compounding the problem is poor public awareness about IVF, with 78% of the population unaware of it altogether, and misconceptions surrounding it, such as fears of multiple births, caesarean sections, and birth defects,3Ali S Sophie R Imam AM et al.Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study.BMC Public Health. 2011; 11: 760Crossref PubMed Scopus (59) Google Scholar which show a minimal increase with IVF of around 1%.4Weckstein L Are birth defects more common with IVF?. Reproductive Science Center, June 4, 2019https://rscbayarea.com/blog/birth-defects-ivfDate accessed: March 15, 2024Google Scholar Furthermore, poor access to IVF facilities and qualified professionals in the country creates a geographical barrier, especially for people in rural areas. In several Arabic countries such as Saudi Arabia, the United Arab Emirates, and Qatar, similar socioreligious beliefs have not hindered the fast-growing acceptance of IVF. This advancement is because of governmental support, part or full insurance coverage of treatment costs, social and religious values of childbearing, and the role of children in family stability. The cost of IVF treatment averages less than US$2000 in Iran, compared with $15 000 and at times over $20 000 in the UK and USA.5Raadina HealthIVF in Iran. Raadina Health.https://raadinahealth.com/en/treatments/ivfDate accessed: May 31, 2024Google Scholar In Qatar, the Government has implemented policies supporting IVF, with initiatives such as subsidising treatment costs and offering financial aid to people in need. There are few effective interventions to improve access to IVF in Pakistan. To destigmatise IVF, the Government should reduce treatment costs. This reduction could be achieved through subsidies and cost-effective plans for couples without children who are prioritised for assistance. Efforts to increase the availability of IVF resources and clinics across the country are important. Raising public awareness of IVF is crucial. Integrating infertility education into the school curriculum and launching targeted social media campaigns can broaden the public's understanding and dispel misconceptions. We declare no competing interests.