Middle East

Breaking the Taboo of Infertility and the Use of Assisted Reproductive Technologies in Kuwait

by Mariam Behbehani

A couple walk on the seaside near Souk Sharq, Kuwait City. Source: Azhar Munir, Flickr.

Looking for a lifelong partnership, finding the right person, planning for the big day, getting married, then happily announcing the arrival of the new baby; the couple becomes a family, and the natural desire of having offspring is satisfied. Unfortunately, this is not the story of all couples. For some, seasons and even years pass while they are anticipating the later moment. To make it happen, they need to face the hidden problem of infertility.

According to the World Health Organization, infertility is defined as a disease in the male or/and female reproductive system affecting their capability to conceive. It is estimated to affect one out of six couples in the conceiving age. Fortunately, reproductive medicine was developed to help couples struggling with infertility. Treatments ranging from medications to more invasive procedures are available for such couples.

Treatment cycles, stimulation shots, IVF, and frozen cycles are common jargon for infertility patients; yet are a mystery for the public unless they have second-hand experience with infertility. The infertility journey is charged with too many emotions, anticipation, hope, and even disappointments. Once a couple starts this journey, their days are weighted with daily injections, scanning appointments, blood tests, and regular changes of plans. Although infertility treatments, or assisted reproductive technologies, help some couples conceive, these treatments have limited success rates.

These treatments come with a price list that often hinders couples from using them. This forces the couple to make large financial and economic sacrifices beyond their capabilities. In many cases, despite all investigations, treatments, and expenditures, the treatment cycle does not lead to a successful pregnancy. This common incident leaves the couple with devastating financial and economic losses, in addition to the emotional and physical burdens.

Studies on assisted reproductive medicine show that, on average, couples need at least three in vitro fertilization (IVF) cycles to achieve one successful pregnancy.  In another study, the authors find that assisted reproductive technologies have shown higher success rates within five years of continuous treatments. Regarding financial costs of infertility treatments, it is estimated that the average cost per complete treatment cycle, including investigations, medications, and interventions, is $12,000. Additionally, in the case of patients needing add-ons to the routine treatment, such as pre-implantation genetic testing or embryo freezing, the cost escalates to $27,000 per cycle.

Other than the huge financial expenditures and the psychological and social tensions that patients experience, the loss of productivity at work is a significant consequence on working women.  Studies – such as Krol, Brouwer & Rutter; Imai et al.; Yilmaz, Yazici & Benli – show the impact of infertility treatments on the work life of women. The effects are seen in the difficulty of managing between work and treatment, the decreased quality of work, days taken off, and presenteeism. To date, health care policy considers infertility treatments as a luxury, although it is involuntary for couples in need of medical assistance to conceive. Affected individuals handle escalating costs of treatments, particularly when facing repeated treatment failure or needing added-on interventions to the routine treatment.

In my research project ‘Investigating the Financial and Socioeconomic Costs of Infertility Treatments in Kuwait: Patients’ Perspective’, my objective is to study the extent of patients’ financial expenditure and loss of productivity due to infertility treatments. The project also supports the affected individuals through drawing the attention of policy makers to infertility as an involuntary treatment requiring an insurance policy to cover its large costs. This study is questionnaire based, and it is designed to assess couples’ out-of-pocket expenditure on infertility treatment, as well as impact on working women during treatment phase. From the perspective of reproductive medicine, infertility treatments do not guarantee a successful pregnancy and the birth of a healthy baby. Nevertheless, will healthcare policy support patients’ involuntary childlessness? This understudied issue is worth to be raised.

[To read more on this and everything Middle East, the LSE Middle East Centre Library is now open for browsing and borrowing for LSE students and staff. For more information, please visit the MEC Library page.]

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