Fertility Physicians’ Opinions and Attitudes on Access to Assisted Reproductive Technology: An Asia-Pacific Perspective

Abstract

Background: Fertility physicians are gatekeepers of assisted reproductive technology (ART) and have immediate control over access to fertility care. However, little is understood about their attitudes and willingness to provide and support different procedures. Therefore, we examined fertility physicians’ perspectives on support of public funding and willingness to provide care in various scenarios. Methods: We invited fertility physicians attending the 8th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2018) to participate in a 10-minute survey. Participants completed the survey anonymously and in private. Results: 78 out of 105 fertility physicians from 12 countries completed the survey (response rate = 74.3%). Mean age was 44.9 years (SD = 11.1). A majority of respondents supported public funding for ART: 76.3% for intrauterine insemination and 80.5% for in vitro fertilization. For controversial procedures, a majority agreed to provide social egg freezing (88.5%) compared to sex selection (25.6%) and gene editing for nonmedical reasons (19.2%), p < 0.001 for both comparisons. Support for public funding was also significantly higher for social egg freezing (51.3%) compared to sex selection (23.1%) and gene editing for nonmedical reasons (20.5%), p < 0.001 for both comparisons. For eligibility criteria, willingness to provide treatment to single women (50.0%) was significantly higher compared to other nontraditional family structures — single men (33.3%), p < 0.001, male homosexual couples (33.3%), p = 0.002, female homosexual couples (32.1%), p = 0.001 and unmarried heterosexual couples (32.1%), p = 0.004. Consistently, support for public finding was significantly higher for single women (32.1%) compared to single men (23.1%), p = 0.013, male homosexual couples (20.5%), p = 0.020, and unmarried heterosexual couples (20.5%), p = 0.006. Conclusions: These results show support for public funding and conservative opinions toward ART for nontraditional family structures among physicians in the Asia-Pacific region.