Main topics in assisted reproductive market: A scoping review

PLOS ONE RESEARCH ARTICLE Main topics in assisted reproductive market: A scoping review Janaina Ferreira Aderaldo ID1,2, Beatriz Helena Dantas Rodrigues de Albuquerque1, Maryana Thalyta Ferreira Câmara de Oliveira1, Mychelle de Medeiros Garcia Torres1,2, Daniel Carlos Ferreira Lanza ID1* 1 Applied Molecular Biology Lab (LAPLIC), Biochemistry Department, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil, 2 Januário Cicco´s University Hospital (MEJC), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 * Abstract Background OPEN ACCESS Citation: Aderaldo JF, Rodrigues de Albuquerque BHD, Câmara de Oliveira MTF, de Medeiros Garcia Torres M, Lanza DCF (2023) Main topics in assisted reproductive market: A scoping review. PLoS ONE 18(8): e0284099. https://doi.org/ 10.1371/journal.pone.0284099 Editor: Meijia Zhang, China Agricultural University, CHINA Received: June 28, 2022 Infertility affects around 12% of couples, and this proportion has been gradually increasing. In this context, the global assisted reproductive technologies (ART) market shows significant expansion, hovering around USD 26 billion in 2019 and is expected to reach USD 45 billion by 2025. Objectives We realized a scoping review of the ART market from academic publications, market reports, and specialized media news, to identify the main terms and characterize them into the main topics in the area. Accepted: March 19, 2023 Published: August 1, 2023 Design Copyright: © 2023 Aderaldo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. We apply an LDA topic modeling process to identify the main terms, and clustered them into semantic synonymous topics. We extracted the patterns and information to these topics and purposed a factor/consequence correlation to them. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: This study was funded by Coordenação de Aperfeiçoamento de Pessoal de Nı́vel Superior (CAPES). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript Competing interests: The authors declare that they have no competing interests. Results We found 2,232 academic papers and selected 632 to include in the automatic term detection. We also included 34 market reports and seven notices produced by specialized enterprises. Were identified 121 most relevant cited terms covering 7,806 citations. These terms were manually aggregated into 10 topics based on semantic similarity: neutral terms (37.2%), economic aspects (17.6%), in vitro fertilization (IVF) commodities & cross-border reproductive care (CBRC) (10.6%), geographic distribution (9.5%), social aspects (7%), regulation (6%), trends & concerns (3.9%), accessibility (3.4%), internet influence (2.9%), and fertility preservation for non-medical reasons (2%). PLOS ONE | https://doi.org/10.1371/journal.pone.0284099 August 1, 2023 1 / 20 PLOS ONE Main topics in assisted reproductive market: a scoping review Discussion The analysis indicates a market with expressive complexity. Most terms were associated with more than one topic, indicating the synergism of this market’s behavior. Only seven terms related to economic aspects, surrogacy and donation represent around 50% of the citations. Except for the topic formed by generic terms, the topic of the economic aspects was the most represented, reflecting macro perspectives such as a-la-carte standard of treatments, many clinics operating on a small/medium scale, and the recent formation of conglomerates. The IVF commodities & CBRC topic brings an overview of gametes pricing and transnational surrogacy, and its regulation. The topic of geographic distribution indicates that that the Asia-Pacific (APAC) market has the most significant growth potential in all fields. Despite the increase in supply and demand for infertility treatments and technological advances in recent decades, the success rate of IVF cycles remains at around 30%. Terms referring to research and development or technical improvement were not identified in a significant way in this review. Conclusions The formation of topics by semantic similarity proved to be an initial path for the elaboration of in-depth studies on the dynamics between several factors, for this, we present the panel classifying main terms into factors (demand, pent-up demand, or distributive) or ART market consequences. Through this approach, it was possible to observe that most of the works addresses economic aspects, regulation and geographic aspects and that topics related to research and improvement have not been addressed. In this way, we highlight the need to deepen the analysis of market elements that may be related to increased efficiency of IVF in the technical field. Introduction Rationale Infertility is currently defined as a failure to achieve a clinical pregnancy after at least one year of regular attempts [1], which was later updated to include physiological or psychological conditions incompatible with natural meeting of gametes [2]. It affects between 8% and 12% of couples globally [3], and this proportion is gradually increasing [1, 4] because of multiple causes, such as the modern lifestyle, diseases, and the postponement of parenthood [5–7]. In that context, it is estimated that half of the infertile couples never seek fertility [8], and the investigation of the reasons reveals a complex product of the national public and private health policies and economic, political, and cultural factors [9–11]. However, the global assisted reproductive technology (ART) market expanded in clinic numbers and procedures [9], The ART market services were around USD 26 billion in 2019 [12] and are expected to reach USD 45 billion by 2025 [5]. Between 1997 and 2016, ART treatments have increased more than five-fold in Europe, 4.6-fold in North America, and threefold in Australia and New Zealand [13, 14]. The distribution of this billionaire market is heterogeneous due to complex clustering factors like unequal regulatory restrictions, local procedures practices, and socio-cultural differences associated with disposable income [7, 15–18]. Despite the volume of information about PLOS ONE | https://doi.org/10.1371/journal.pone.0284099 August 1, 2023 2 / 20 PLOS ONE Main topics in assisted reproductive market: a scoping review several factors that compose this market, there is no structured analysis of these factors in clusters. For this reason, we produce this scoping review for the identification of the main terms and topics cited in ART market texts. This is an appropriate tool for examining emerging evidenc (...truncated)