Geographies of Fertility Treatment: A Study of Availability, Accessibility, Awareness and Experience in England and Ireland

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This research is proposed at a time when access to fertilitytreatment is becoming increasingly rationed and the barriersfaced by people wishing to access these services arebecoming more diverse and severe (Marsh, 2018). Freeaccess to NHS IVF-related treatment in England is beingsignificantly reduced, creating a postcode lottery and forcingsome people to relocate (Khan, 2017; Marsh, 2018). InIreland, by contrast, IVF is not publicly funded at all andaccessing treatments can prove costly (Holland, 2018). NonIVF forms of treatment are available including RestorativeReproductive Medicine (RRM) which can still be expensive.RRM aims to restore the natural reproductive function ratherthan bypass it as is the case with IVF-related treatments(Neo Fertility, 2018; IIRRM, 2018). However, these servicesremain largely unknown to people and academic researchconcerning access appears scarce. The aim of this researchis to examine and compare the availability, accessibility andawareness of all forms of fertility treatment in England andIreland and analyse how people experience accessing theseservices. Two key objectives will be addressed in order toanswer this overarching research question:1. Examine, compare and contrast the aspatial and spatialfactors affecting inequities of availability and access inrelation to all forms of fertility treatment services in Englandand Ireland.2. Analyse approaches to fertility treatment provision andawareness in each country and examine how peopleexperience the process of accessing these services.This research sits at the conceptual and empiricalintersections of critical social scientific approaches to health- spanning geography, sociology and anthropology - andpublic health. The proposed research will, in the firstinstance, inform health geography by identifying how fertilitytreatment access, awareness and experience is affected byaspatial and spatial factors across different geographicalscales. Medical anthropology will be addressed by examiningthe relationships between local, regional and national politicsand cultural, social and religious norms, and how this affectshealth service provision and accessibility. This research willcontribute to medical sociology by determining how socialfactors, including behaviours of people seeking treatment,medical institutions, healthcare providers and governments,affect accessibility, awareness and access experience. Thiswork will inform debates in public health, social policy andpolitics by analysing equity of access to fertility treatmentand examining how treatment is accessed and funded.