Abstract
BACKGROUND: The socioeconomic inequalities play a major role in determining the access and use of assisted reproductive technology (ART) by infertile couples in low- and middle-income nations. Our goal was to identify and compare the sociodemographic variables related to the access and use of ART between the couples who use it and those who do not in Pakistan. METHODS: The comparative cross-sectional study was conducted at the infertility clinic of CMH Multan between January 1, 2024 and June 30, 2024. Women (aged 18-45 years) were consecutively recruited to the ART group (n = 150) and the non-ART group (n = 150). A structured questionnaire was used in gathering sociodemographic data, medical history, and treatment information. The t-tests and χ (2) tests were used to conduct descriptive and bivariate analyses. The variables with p 0.05 were put into a multivariate binary logistic regression model to determine independent predictors of ART use. RESULTS: Women in the ART group were older (mean age 31.25 ± 4.69 years) and had longer infertility periods, were better educated and had better incomes, were more likely to be employed, urban dwellers, and had nuclear families. Multivariate analysis has revealed that higher education, urban residence, nuclear family, prolonged infertility, and ART awareness were independent predictors of ART use (p < 0.05). The most prevalent barrier (46%) to treatment access was the presence of financial constraints. CONCLUSIONS: The socioeconomic status is a key determinant of ART uptake in Pakistan. The affordability, the expansion of ART services provided by the public sector, and the spreading of awareness are needed to achieve fair access to infertility care.