The Politics of Parenthood: Comparing Global Approaches to IVF Policy and Equity

Introduction: In vitro fertilisation (IVF) has become an integral component of reproductive health, enabling millions of individuals, couples, and others to achieve intended, non-adoptive parenthood. However, governance of IVF remains highly variable, shaped by statutory law, religion, culture, and resource allocation. While some countries have developed robust statutory frameworks, others rely on interim codes or fragmented commissioning policies, creating inequities in access, safety, and inclusivity. Methods: A systematic methodology was developed in accordance with the PRISMA guidelines to examine IVF policies published across the United Kingdom (UK) and the continents of Asia, Africa, Europe, Oceania and South America. All policy documents available in a digital format from 20th of August 1990, to 2025 were included. National policies, laws, and regional commissioning frameworks explicitly addressing IVF policies were also included. Data extraction captured the statutory basis, eligibility criteria, financing models, clinical standards, and ethical provisions. A thematic, contextual and comparative analysis was conducted, complemented by descriptive statistics summarising age limits, body mass index (BMI) thresholds, inclusivity, and financing arrangements. Results: Analysis revealed wide heterogeneity in IVF policies. Marital restrictions in Iran, the Maldives, China, and Texas excluded single and LGBTQIA+ individuals, whereas South Africa, Wales, Montana, and Oregon guaranteed inclusivity. Public funding was comprehensive in South Korea and Wales but limited in Oman, Jersey, and several U.S. states. Clinical standards such as single embryo transfer were common, yet policies on gamete donation, storage, and consent varied substantially, undermining equity. Conclusion: IVF policy globally remains fragmented, reflecting divergent intersections of law, religion, and resource allocation. Statutory anchors and inclusive financing models support safety and access, yet restrictive eligibility criteria and fragmented commissioning perpetuate inequity. Regulation informed by equity and inclusivity factors, as well as integration into reproductive health strategies, is needed to ensure equitable and universal access to IVF.