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

This research is proposed at a time when access to fertility
treatment is becoming increasingly rationed and the barriers
faced by people wishing to access these services are
becoming more diverse and severe (Marsh, 2018). Free
access to NHS IVF-related treatment in England is being
significantly reduced, creating a postcode lottery and forcing
some people to relocate (Khan, 2017; Marsh, 2018). In
Ireland, by contrast, IVF is not publicly funded at all and
accessing treatments can prove costly (Holland, 2018). NonIVF forms of treatment are available including Restorative
Reproductive Medicine (RRM) which can still be expensive.
RRM aims to restore the natural reproductive function rather
than bypass it as is the case with IVF-related treatments
(Neo Fertility, 2018; IIRRM, 2018). However, these services
remain largely unknown to people and academic research
concerning access appears scarce. The aim of this research
is to examine and compare the availability, accessibility and
awareness of all forms of fertility treatment in England and
Ireland and analyse how people experience accessing these
services. Two key objectives will be addressed in order to
answer this overarching research question:
1. Examine, compare and contrast the aspatial and spatial
factors affecting inequities of availability and access in
relation to all forms of fertility treatment services in England
and Ireland.
2. Analyse approaches to fertility treatment provision and
awareness in each country and examine how people
experience the process of accessing these services.
This research sits at the conceptual and empirical
intersections of critical social scientific approaches to health
- spanning geography, sociology and anthropology - and
public health. The proposed research will, in the first
instance, inform health geography by identifying how fertility
treatment access, awareness and experience is affected by
aspatial and spatial factors across different geographical
scales. Medical anthropology will be addressed by examining
the relationships between local, regional and national politics
and cultural, social and religious norms, and how this affects
health service provision and accessibility. This research will
contribute to medical sociology by determining how social
factors, including behaviours of people seeking treatment,
medical institutions, healthcare providers and governments,
affect accessibility, awareness and access experience. This
work will inform debates in public health, social policy and
politics by analysing equity of access to fertility treatment
and examining how treatment is accessed and funded.