From policy to patients: how history and culture shape access to public fertility services
1
Maynooth University, Maynooth, Ireland
Popul. Med. 2026;8(Supplement Supplement 1):A3618
ABSTRACT
BACKGROUND:
Infertility is a significant public health issue, affecting one in six couples globally1 and approximately 25 million people in Europe2. Beyond clinical implications, infertility has social, psychological, and economic consequences. Despite recognition of reproductive health as a public health priority, fertility services in Ireland have historically developed, remained fragmented, and relied heavily on private provision3. Over 17% of couples experienced fertility difficulties4, yet Ireland lacked comprehensive legislation governing Assisted Human Reproduction until recently, when a publicly funded fertility model of care was introduced. This study examines how historical contexts continue to shape fertility policy development and influence equity in access to Irish reproductive healthcare.
METHODS:
A qualitative archival media analysis was conducted on 237 newspaper articles published between 1992 and 2024 retrieved through LexisNexis Database. They were thematically coded to examine how fertility care has been framed in public and policy discourse. Findings were categorised in domains around societal context, policymaking processes, and community experiences to assess how healthcare policy in fertility care evolved over the years.
RESULTS:
Couples in Ireland report spending €4,500–€6,000 on private fertility treatment, with diagnostics raising costs to €10,000, often financed through loans, while some travel abroad for more affordable care. Access is largely determined by financial capacity. Historical opposition to assisted reproductive technologies, rooted in Catholic teachings, and cultural stigma has shaped hospital governance and contributed to delays in policy reform. Community organizations highlight the financial and emotional burdens of infertility and advocate for inclusive, publicly funded fertility services addressing diverse population needs.
CONCLUSIONS:
Publicly funded fertility care in Ireland has historically been constrained by an absence of public policy, cultural stigma, and financial barriers, leading to inequitable access. Addressing these structural and socio-cultural influences is essential to advance inclusive, population-centered reproductive health policies, reduce disparities, and ensure equitable access to fertility services.
Infertility is a significant public health issue, affecting one in six couples globally1 and approximately 25 million people in Europe2. Beyond clinical implications, infertility has social, psychological, and economic consequences. Despite recognition of reproductive health as a public health priority, fertility services in Ireland have historically developed, remained fragmented, and relied heavily on private provision3. Over 17% of couples experienced fertility difficulties4, yet Ireland lacked comprehensive legislation governing Assisted Human Reproduction until recently, when a publicly funded fertility model of care was introduced. This study examines how historical contexts continue to shape fertility policy development and influence equity in access to Irish reproductive healthcare.
METHODS:
A qualitative archival media analysis was conducted on 237 newspaper articles published between 1992 and 2024 retrieved through LexisNexis Database. They were thematically coded to examine how fertility care has been framed in public and policy discourse. Findings were categorised in domains around societal context, policymaking processes, and community experiences to assess how healthcare policy in fertility care evolved over the years.
RESULTS:
Couples in Ireland report spending €4,500–€6,000 on private fertility treatment, with diagnostics raising costs to €10,000, often financed through loans, while some travel abroad for more affordable care. Access is largely determined by financial capacity. Historical opposition to assisted reproductive technologies, rooted in Catholic teachings, and cultural stigma has shaped hospital governance and contributed to delays in policy reform. Community organizations highlight the financial and emotional burdens of infertility and advocate for inclusive, publicly funded fertility services addressing diverse population needs.
CONCLUSIONS:
Publicly funded fertility care in Ireland has historically been constrained by an absence of public policy, cultural stigma, and financial barriers, leading to inequitable access. Addressing these structural and socio-cultural influences is essential to advance inclusive, population-centered reproductive health policies, reduce disparities, and ensure equitable access to fertility services.
| eISSN: | 2654-1459 |
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