A Study on Access to Assisted Reproduction Treatment, Factors for Its Use and Success Rates in Spain
Keywords:
Infertility, Socio-demographic Profile, Assisted ReproductionAbstract
This article analyses the current use of medically assisted reproductive technologies in Spain and describes the profiles of women using them or wishing to use them. Data from the 2018 Fertility Survey and a simple probit regression model with instrumental variables were employed to examine the factors associated with the use and success of these treatments. Married women with higher socioeconomic status and primary infertility are more likely to access them. Younger generations are resorting to them more often, possibly due to delayed childbearing, improved technologies, family changes and
legal developments. The main barrier to accessing them is economic, which indicates that there is an unrealised potential use. Finally, when correcting for endogeneity, no statistical association was found between socio-demographic variables and the treatments’ success.
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Adserà, Alícia y Lozano, Mariona (2021). «¿Por qué las mujeres no tienen todos los hijos que dicen querer tener?». Dossier Monográfico: Estado del bienestar, ciclo vital y demografía, 10: 25-33. Observatorio Social, Fundación «la Caixa».
Alcañiz, Mercedes y Monteiro, Rosa (2016). «She-austerity. Precariedad y desigualdad laboral de las mujeres en el sur de Europa». Convergencia, 72: 39-68.
Alon, Ido; Guimon, José y Urbanos-Garrido, Rosa (2019). «What to expect from assisted reproductive technologies? Experts’ forecasts for the next two decades». Technological Forecasting and Social Change, 148: 119722. doi: https://doi.org/10.1016/j.techfore.2019.119722
Alon, Ido y Pinilla, Jaime (2021). «Assisted reproduction in Spain: Outcome and socioeconomic determinants of access». International Journal for Equity in Health, 20: 156. doi: https://doi.org/10.1186/s12939-021-01438-x
Angrist, Joshua D. (1991). Instrumental variables estimation of average treatment effects in econometrics and epidemiology. NBER Working Paper. doi: https://doi.org/10.3386/t0115
Angrist, Joshua D. y Pischke, Jörn-Steffe (2009). Mostly harmless econometrics: An empiricist’s companion. Princeton University Press.
Audibert, Céline y Glass, Daniel (2015). «A global perspective on assisted reproductive technology fertility treatment: An 8-country fertility specialist survey». Reproductive Biology and Endocrinology, 13: 133. doi: https://doi.org/10.1186/s12958-015-0131-z
Aurrekoetxea-Casaus, Maite; Ronda, Lorena y Govillard, Leila (2022). «Gender differences in attitudes toward assisted reproduction in the Spanish population: The weight of religiosity and conservatism». Frontiers in Political Science, 4: 1027997. doi: https://doi.org/10.3389/fpos.2022.1027997
Baranda Ortiz, Aidee (2019). «Factores que interfieren en el incumplimiento de las expectativas reproductivas de las mujeres españolas». Inguruak, 67: 39. doi: https://doi.org/10.18543/inguruak-67-2019-art03
Billari, Francesco; Goisis, Alice; Liefbroer, Art; Settersten, Richard A; Aassve, Arnie; Hagestad, Gunhild y Spéder, Zsolt (2011). «Social age deadlines for the childbearing of women and men». Human Reproduction, 26(3): 616-622. doi: https://doi.org/10.1093/humrep/deq360
Boivin, Jacky; Bunting, Laura; Collins, John A. y Nygren, Karl G. (2007). «International estimates of infertility prevalence and treatment-seeking: Potential need and demand for infertility medical care». Human Reproduction, 22(6): 1506-1512. doi: https://doi.org/10.1093/humrep/dem046
Bueno, Xiana (2020). «Fertility decisions in transition: Young adults’ perceptions on fertility three decades apart in Spain». The History of the Family, 25(3): 386-405. doi: https://doi.org/10.1080/1081602X.2019.1686049
Castilla, José A.; Hernández, Enrique; Cabello, Yolanda; Navarro, José L.; Hernández, Juana; Gomez, José L.; Pajuelo, Nuria; Marqueta, Javier y Coroleu, Bonaventura (2009). «Assisted reproductive technologies in public and private clinics». Reproductive BioMedicine Online, 19(6): 872-878. doi: https://doi.org/10.1016/j.rbmo.2009.09.028
Chambers, Georgina M.; Hoang, Van Phuong; Sullivan, Elizabeth A.; Chapman, Michael G.; Ishihara, Osamu; Zegers-Hochschild, Fernando; Nygren, Karl G. y Adamson, David G. (2014). «The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: An international analysis». Fertility and Sterility, 101(1):191-198. doi: https://doi.org/10.1016/j.fertnstert.2013.09.005
Rey, Alberto del; Grande, Rafael y García-Gómez, Jesús (2022). «Transiciones a la maternidad a través de las generaciones: Factores causales del nacimiento del primer hijo en España». Revista Española de Sociología, 31(2): a108. doi: https://doi.org/10.22325/fes/res.2022.108
Devolder, Daniel y Borisova, Evgeniya (2022). «Demographic impact of in vitro fertilization in Spain». Medicina Reproductiva y Embriología Clínica, 9(2): 100115. doi: https://doi.org/10.1016/j.medre.2022.100115
Dhalwani, Nafeesa N.; Fiaschi, Linda; West, Joe y Tata, Laila J. (2013). «Occurrence of fertility problems presenting to primary care: Population-level estimates of clinical burden and socioeconomic inequalities across the UK». Human Reproduction, 28(4): 960-968. doi: https://doi.org/10.1093/humrep/des451
Fauser, Bart C. J. M. (2019). «Towards the global coverage of a unified registry of IVF outcomes». Reproductive BioMedicine Online, 38(2): 133-137. doi: https://doi.org/10.1016/j.rbmo.2018.12.001
Fauser, Bart C. J. M.; Boivin, Jacky; Barri, Pedro N.; Tarlatzis, Basil C.; Schmidt, Lone y Levy-Toledano, Rachel (2019). «Beliefs, attitudes, and funding of assisted reproductive technology: Public perception of over 6,000 respondents from 6 European countries». PLoS ONE, 14(1): e0211150. doi: https://doi.org/10.1371/journal.pone.0211150
Goisis, Alice; Håberg, Siri E.; Hanevik, Hans I.; Magnus, Maria C. y Kravdal, Øystein (2020). «The demographics of assisted reproductive technology births in a Nordic country». Human Reproduction, 35(6): 1441-1450. doi: https://doi.org/10.1093/humrep/deaa055
Goisis, Alice; Fallesen, Peter; Seiz, Marta; Salazar, Leire; Eremenko, Tatiana y Cozzani, Marco (2024). «Educational gradients in the prevalence of MAR births in a comparative perspective». Fertility and Sterility, 122(4): 648-657. doi: https://doi.org/10.1016/j.fertnstert.2024.05.149
Harris, Katie; Burley, Hugh; McLachlan, Robert; Bowman, Mark; Macaldowie, Alan; Taylor, Kate; Chapman, Michael y Chambers, Georgina M. (2016). «Socio-economic disparities in access to assisted reproductive technologies in Australia». Reproductive BioMedicine Online, 33: 575-584. doi: https://doi.org/10.1016/j.rbmo.2016.07.012
Kocourkova, Jirina; Burcin, Boris y Kucera, Tomas (2014). «Demographic relevancy of increased use of assisted reproduction in European countries. » Reproductive Health, 11(1): 37. doi: https://doi.org/10.1186/1742-4755-11-37
Lazzari, Ester; Gray, Edith y Chambers, Georgina M. (2021). «The contribution of ART to fertility rates and parity transition: An analysis of Australian data». Demographic Research, 45(34): 1081-1096. doi: https://doi.org/10.4054/DemRes.2021.45.35
Lazzari, Ester; Baffour, Bernard y Chambers, Georgina M. (2022). «Residential proximity to a fertility clinic is independently associated with likelihood of women having ART and IUI treatment». Human Reproduction, 37(11): 2662-2671. doi: https://doi.org/10.1093/humrep/deac205
López-Rodríguez, Silvia (2017). «Políticas públicas y producción de espacios de vulnerabilidad: La construcción de la mujer-madre en el discurso político en España». Revista Española de Ciencia Política, 44: 97-120. doi: https://doi.org/10.21308/recp.44.04
Martínez-Martínez, Antonio Luis y Bote, Marcos (2019). «Concilia o revienta: Determinantes socioeconómicos y demográficos del uso de técnicas de reproducción humana asistida en perspectiva territorial». Política y Sociedad, 56(3): 583-601. doi: https://doi.org/10.5209/poso.60510
McCarthy-Keith, Desirée M.; Schisterman, Enrique F.; Robinson, Randal D.; O’Leary, Kathleen; Lucidi, Richard S. y Armstrong, Alicia Y. (2010). «Will decreasing assisted reproduction technology costs improve utilization and outcomes among minority women?». Fertility and Sterility, 94(7): 2587-2589. doi: https://doi.org/10.1016/j.fertnstert.2010.02.021
Melo-Martin, Inmaculada de (2019). «Assisted reproductive technology in Spain: Considering women’s interests». Cambridge Quarterly of Healthcare Ethics, 8(3): 228-235. doi: https://doi.org/10.1017/S0963180109090379
Norwitz, Errol R.; Edusa, Valentine y Park, Joong S. (2005). «Maternal physiology and complications of multiple pregnancy». Seminars in Perinatology, 29(5): 338-348. doi: https://doi.org/10.1053/j.semperi.2005.08.002
Olsen, Jens; Küppers-Chinnow, Marion y Spinelli, Antonino (1996). «Seeking medical help for subfecundity: A study based upon surveys in five European countries». Fertility and Sterility, 66(1): 95-100. doi: https://doi.org/10.1016/S0015-0282(16)58393-9
Passet-Wittig, Jasmin y Bujard, Martin (2021). Medically assisted reproduction in developed countries: Overview and societal challenges. En: Schneider, N. F. y Kreyenfeld, M. (eds.). Research handbook on the sociology of the family (pp. 417-438). United Kingdom: Edward Elgar Publishing. doi: https://doi.org/10.4337/9781788975544.00042
Präg, Patrick y Mills, Melinda C. (2017). «Cultural determinants influence assisted reproduction usage in Europe more than economic and demographic factors». Human Reproduction, 32(11): 2305-2314. doi: https://doi.org/10.1093/humrep/dex298
Rochebrochard, Elise de la y Thonneau, Patrick (2005). «Paternal age: Are the risks of infecundity and miscarriage higher when the man is aged 40 years or over?». Revue d'Épidémiologie et de Santé Publique, 53(2): 47-55. doi: https://doi.org/10.1016/S0398-7620(05)84767-4
Romero Guadix, Bárbara; Díaz Ríos, Patricia; Prados Mondéjar, Fernando; Hernández, Elisa; Cuevas, Irene; Monzó, Ana; Martín, Berta; Llaneza, Plácido; Casas, Ana B.; Castel, Ana B.; Gaspar, Beatriz; Sanz, Clara; Saiz, Maria J.; Peralta, Sara; Iñarra, Maria J. y Castilla Alcalá, Jose A. (2022). «Influencia de los factores socioeconómicos en el acceso a las técnicas de reproducción asistida». Medicina Reproductiva y Embriología Clínica, 9(1): 100111. doi: https://doi.org/10.1016/j.medre.2021.100111
Sobotka, Tomas; Hansen, Martin A.; Jensen, Tina K.; Pedersen, Anette T.; Lutz, Wolfgand y Skakkebæk, Niels E. (2008). «The contribution of assisted reproduction to completed fertility: An analysis of Danish data». Population and Development Review, 34(1): 79-101. doi: https://doi.org/10.1111/j.1728-4457.2008.00206.x
Sociedad Española de Fertilidad (2018). Registro Nacional de Actividad - Técnicas de Reproducción Asistida: Informe estadístico de Técnicas de Reproducción Asistida.
Stock, James H. y Yoho, Mothiro (2005). Asymptotic distribution of instrumental variables statistics with many instruments. En: Andrews, D. W. K. y Stock, J. H. (eds.). Identification and inference for econometric models (pp. 109-120). Cambridge University Press.
Suero Garcia, Cristina (2024). The moderating role of women’s educational attainment in shaping fertility behaviours in Spain. Castro Martín, María T. y Martín García, Teresa (dirs.), Madrid: Universidad Carlos III. [Tesis doctoral].
Wooldridge, Jeffrey M. (2002). Econometric analysis of cross section and panel data. MIT Press.
Zegers-Hochschild, Fernando; Adamson, David G.; Dyer, Silke; Racowsky, Catherine; Mouzon, Jacques de; Sokol, Rebecca; Rienzi, Laura; Sunde, Arne; Schmidt, Lone; Cooke, Ian D.; Simpson, Joe L. y Poel, Sheryl van der (2017). «The international glossary on infertility and fertility care». Human Reproduction, 32(9): 1786-1801. doi: https://doi.org/10.1016/j.fertnstert.2017.06.005
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