Latin America and access to Assisted Reproductive Techniques: A Brazilian perspective

INTRODUCTION: In Brazil, as in all Latin America, access to infertility care, including assisted reproductive technology (ART) is on debate. This paper evaluates the availability and access of Brazilian couples to ART services. METHODS: It is a qualitative study conducted about the Brazilian possibilities of ART in the public sector. A questionnaire was sent by e-mail to 14 public centers identified as providing ART (IVF/ICSI and/or IUI), with questions about their performance on 2013. The questionnaire was objective with seven questions. It was asked the number of patients seen for 1(st) time in 2013, and number IVF procedures and/or IUI in this interval, the source of funds to support the center, the input source of the patients, who pays for medications and how much (%), number of cycles or age limitations, whether or not oocyte donation is held. RESULTS: There were 11 answers out of 14 and during 2013 in public centers were performed 1088 IUI cycles plus 4044 IVF/ICSI cycles. The waiting lists of patients can vary from 300 to 1500 and wait from 6 months to 4 years. CONCLUSIONS: As infertility goes, charges remain incompatible with the financial possibilities of the majority of Brazilian population. The Brazilian government should consider buying cycles in private accredited centers to offer ART procedures at no cost to low-income populations. Other possibility is to state as mandatory that Health Insurance Assistance Companies cover ART treatments, making it accessible for a large part of the population.