We are living in unprecedented times. A recent New York Times article posed many questions for mothers currently going through infertility procedures and surrogacy. According to the article, thousands of babies born to surrogate mothers will be left “stranded” in Ukraine as covid-19 restricts travel across many countries.
The world of assisted reproductive technology (ART), offering services like in vitro fertilisation (IVF), surrogacy, egg and sperm donation, among others, has been on edge since the outbreak.
As the coronavirus spreads, governments and professionals are forced to ask a more fundamental question: “Is assisted reproduction an essential service?” .
In March 2020, the professional body in South Africa, the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (Sasreg), issued a guideline suspending all non-urgent fertility treatments. Later they then published a legal opinion allowing new fertility treatments for almost all categories of patients, in essence classifying fertility treatment as an essential service.
Should one pursue any kind of treatment that is not life threatening when there is a deadly virus still going around? These dilemmas go beyond the pandemic context, especially in countries with limited resources and health care.
In South Africa, reproductive health services, much like the rest of the health system, are riddled by debilitating inequities based on race and class. The total health care expenditure in South Africa in 2017 was about 8.8% of GDP, nearly 60% goes directly towards the private sector, which only services 16% of the population.
The pandemic provides us the opportunity to reflect on what and who is deemed “essential”, and at what cost.