Dados do Trabalho

Title

TREATMENT OF ASSISTED REPRODUCTION BY THE UNITED HEALTH SYSTEM IN BRAZIL

Objective

This study aims to evaluate the distribution of Assisted Reproduction Treatments (ART) in private and public networks throughout Brazilian territory.

Methods

It is a bibliographic review based on indexed scientific articles in Portuguese and English, from the years 2010 to 2023, obtained from databases such as PubMed, Scielo, and the Ministry of Health. The search was conducted using keywords such as "Infertility," "Sistema Único de Saúde or SUS" (Brazil's Public Health System), "Assisted Reproduction Techniques or ART," and "Reproductive Rights." Inclusion criteria comprised studies conducted in Brazil, those that assessed the assistance rates provided by the SUS, and studies related to ART within the SUS. Eight articles were gathered, of which 2 were excluded due to duplicates, title and abstract reading, resulting in 6 selected articles.

Results

Article 226 of the Brazilian Federal Constitution guarantees access to scientifically accepted and safe conception and contraception methods, leading to the creation of Ordinance no 426/GM in 2005, which established the National Policy of Integral Care in Assisted Reproduction within the SUS, aiming to provide comprehensive assistance to infertile couples at all levels [1]. A qualitative study from 2014 evaluated the availability of ART in Brazil, indicating that only 5% of consultations are conducted through the SUS, and it highlighted the waiting time for patients, ranging from 6 months to 4 years [2]. Another study emphasized that the coverage of assistance expenses is not comprehensive [3]. Various authors point out that ART is not prioritized within public health [2;3;4;5]. In 2022, the 14th Report of the National Embryo Production System - SisEmbrio was published, indicating 80,575 cycles performed in 2020 and 2021, in 170 Assisted Human Reproduction Centers, showing a total of 181 centers across Brazil [6]. Studies show that only 13 of these available clinics offer treatments through the SUS in Brazil (image 1), and both private and public centers are unevenly distributed throughout the territory [5,6].

Conclusion

Given this, it is evident that the availability of these services within the SUS is still limited, and many couples do not have access to such treatments. Strengthening and expanding the policy of integral care in assisted reproduction within the SUS is necessary to reduce geographic and financial inequalities in treatment access. Moreover, it is crucial to invest in research and public policies prioritizing assisted reproduction as a relevant public health issue. Awareness about the importance of reproductive rights and the need for accessible and quality treatments for infertile couples should be promoted both in the context of public health and society at large.

Keywords

Infertility; Sistema Único de Saúde; Assisted Reproduction Techniques; Reproductive Rights