Report on Modern Fertility Treatments and Alignment with Sustainable Development Goals

Infertility is a significant global health challenge, affecting one in five women in the United States alone. Addressing this issue is fundamental to achieving Sustainable Development Goal 3 (Good Health and Well-being), which aims to ensure healthy lives and promote well-being for all at all ages. This report outlines common causes of infertility, recommended actions, and available treatments, highlighting how comprehensive reproductive healthcare contributes to key SDGs.

Proactive Health Management and Lifestyle Factors

Promoting general and reproductive health through informed lifestyle choices is a critical first step in family planning and aligns with the preventative health targets of SDG 3. Individuals are advised to monitor key health indicators and adopt healthy habits.

Key Recommendations for Reproductive Health:

• Menstrual Cycle Monitoring: Regular, predictable menstrual cycles are a primary indicator of healthy ovulation and overall reproductive function.
• Balanced Diet: A diet low in inflammatory foods and carbohydrates, with an emphasis on protein, is recommended.
• Lifestyle Modifications: The restriction of smoking and alcohol consumption is advised for individuals attempting to conceive.

Etiology of Infertility: A Gender-Inclusive Perspective

Infertility can originate from male, female, or combined factors, underscoring the importance of a comprehensive approach that supports SDG 5 (Gender Equality) by addressing the health needs of all partners. Understanding the common causes is essential for diagnosis and treatment, reinforcing the goals of SDG 3.

Common Contributing Factors:

• Female Factors:
  • Ovulatory dysfunction, such as that seen in Polycystic Ovarian Syndrome (PCOS), where an egg is not released monthly.
  • Diminished ovarian reserve (low egg count), a condition that becomes more prevalent with increasing maternal age.
• Male Factors:
  • A common cause is the use of exogenous testosterone, which can significantly impair sperm production and quantity.

Protocols for Seeking Medical Intervention

Timely access to specialized medical care is crucial for improving outcomes and is a core component of SDG 3. The guidelines for when to consult a reproductive endocrinologist are as follows:

1. Immediate Consultation: Individuals with a known history of conditions that may affect fertility, such as endometriosis or prior chemotherapy treatment, should seek immediate evaluation.
2. Consultation After Six Months: Individuals over the age of 35 are advised to see a specialist after six months of attempting to conceive.
3. Consultation After One Year: For those under 35 with no known risk factors, a consultation is recommended after one year.

Advanced Fertility Services and Contribution to Health Equity

The provision of a comprehensive spectrum of fertility treatments ensures access to essential healthcare services, directly supporting SDG 3. Furthermore, by offering inclusive options for diverse family structures, these services advance SDG 5 (Gender Equality) and SDG 10 (Reduced Inequalities).

Available Treatment Modalities:

• Fertility Preservation: Cryopreservation of eggs and sperm.
• Ovulation Induction: Use of medication to stimulate ovulation.
• Intrauterine Insemination (IUI): A procedure to assist with male-factor infertility.
• In Vitro Fertilization (IVF): Advanced reproductive technology for fertilization outside the body.
• Genetic Testing: Services to prevent the transmission of known genetic conditions to offspring.
• Third-Party Reproduction: Inclusive options for same-sex couples or individuals requiring donor eggs, donor sperm, or a gestational carrier.

A Model for Patient-Centered, Integrated Healthcare

A personalized, multi-disciplinary approach to fertility care exemplifies the patient-centered model required to fully realize the objectives of SDG 3. This approach ensures that care is not only medically effective but also compassionate and aligned with individual patient goals.

Core Components of the Patient-Centered Model:

• Personalized Care Plans: Treatment strategies are developed based on the specific goals and circumstances of each patient.
• Interdisciplinary Collaboration: Teams work closely with specialists in oncology, genetics, and primary care to provide integrated and comprehensive care.
• Accessible, State-of-the-Art Facilities: Centralized services ensure that patients have access to all necessary resources throughout their fertility journey.

Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 5: Gender Equality

What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

• Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
  
  Explanation: The article directly addresses this target by focusing on reproductive health, specifically infertility. It provides information on the causes of infertility, lifestyle factors, and when to seek medical advice. It also details the availability of a “whole spectrum of fertility treatment options,” which are essential sexual and reproductive health-care services.
• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
  
  Explanation: The article highlights the provision of quality essential healthcare services at VCU Health. It describes a “patient-centered approach,” “state-of-the-art facilities,” and a wide range of treatments like IVF, IUI, and genetic testing. The fact that “patients come from all over the state” points to efforts to expand access to this specialized care, which is a component of universal health coverage.

SDG 5: Gender Equality

• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.
  
  Explanation: This target is supported by the article’s inclusive approach to reproductive health. It emphasizes that infertility is not just a women’s issue, stating, “both partners can experience infertility issues.” Furthermore, it mentions the availability of services for “same-sex couples,” thereby promoting equal access to reproductive health services regardless of gender or sexual orientation.

Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Indicators for Target 3.7 and 5.6

• Prevalence of Infertility: The article states that “one in five women struggling to get pregnant.” This statistic serves as an indicator of the need for reproductive health services, measuring the proportion of the population requiring care.
• Availability of Comprehensive Fertility Services: The article implies an indicator of service availability by listing a “whole spectrum of fertility treatment options.” This includes “medication to help people ovulate,” “intrauterine inseminations,” “in vitro fertilization (IVF),” “freezing your eggs or sperm,” “genetic testing,” and services for same-sex couples (“donor eggs, donor sperm,” “gestational carrier”). The existence of this comprehensive list can be used to measure the availability of services.

Indicators for Target 3.8

• Quality of Healthcare: The article implies indicators of quality through its description of a “personalized approach,” “individualized, compassionate care,” and a multidisciplinary team that works with “oncology, genetics and primary care.” These qualitative descriptions point to the quality of the health services being provided.
• Service Coverage: The statement that “Our patients come from all over the state to meet with our fertility specialists” serves as an implied indicator of the service coverage area. It suggests that the facility provides essential specialized care to a broad geographic population, contributing to the goal of universal health coverage.

Table of SDGs, Targets, and Indicators

Source: vcuhealth.org