The decision-making pathway and enablers to the utilization of assisted reproductive technology in Lagos metropolis: an interpretive phenomenological study

Abstract

Women experiencing infertility face barriers to access Assisted Reproductive Technology (ART) services in Nigeria. Despite these barriers, some still access these services. This study explored the decision-making pathway and enablers of the use of ARTs among such persons in Lagos State. Using an interpretive phenomenological approach, we explored the decision-making process and enablers motivating the use of ART services among women who have experienced infertility. An open-ended semi-structured in-depth interview guide was used to collect data that were analyzed thematically. The study found that women who have used ART have had varied experiences resulting from their inability to conceive. The participants reported that they were sad, depressed, angry, and worried a lot about their situation and were dissatisfied after failed attempts. The participants reported other emotional moments where they cried, yelled, read their Bibles, and meditated to always feel better because of their condition, which assisted them in coping with their unmet expectations. Most of the participants received support from their husbands which helped them during their treatments and after failed attempts. The findings also revealed that one of the challenges faced by the participants while they used ART was the financial burden associated with it. In addition, the findings revealed that the decision-making pathway involved personal, interpersonal or relational thought processes to use Assisted Reproductive Technology for assisted conception and enablers which were a mix of emotional support from the mother, spouses, social pressures, information about health condition, professional and lay suggestions all contributed to the eventual use of ARTs. Results of this study indicate that infertile women received different forms of support that enabled the use of ARTs. However, women who used ART services experienced several psychosocial challenges. These ARTs have given infertile and childless couples some ray of hope and the chance to escape the burden and social stigma of childlessness. This study recommends that public health professionals collaborate with ART service providers in providing psychosocial care in addition to basic clinical care for infertile and childless women. Future studies can explore the perspectives of significant others as they played a key role in the decision and motivation to use ART.