Health equity and access to oocyte donation

In many countries women are delaying having children for reasons such as educational pursuits, career goals, or establishing relationships with partners prior to starting a family. As human reproductive physiology does not accommodate the social norms of late reproduction, many women will need medical assistance in order to conceive, including strategies for oocyte preservation and donation. Although innovations in medical technologies now make it much more likely that some women will be able to have children, these new medical possibilities may also lead to inequities in access to care. Oocyte depletion may be the result of cancer treatment, advanced reproductive age, or other etiologies. Because little or no public funding exists in many countries for the medical treatment of oocyte depletion, in these contexts the latest techniques are only available to those who can afford it. This creates great discrepancies among different women in their ability to have children. Table 27.1 shows six examples of national funding and regulation disparities: Australia, Canada, France, Israel, the UK, and the USA.