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Governance of Iran's infertility control policies, with focus on cardiovascular risk care in infertile women
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Bahareh Morshed-Behbahani *   |
| Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran , morshe_@yahoo.com |
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Abstract: (29 Views) |
Abstract
Aim. This study aimed to explain the practice of governance in Iran's infertility control policies, with a specific focus on cardiovascular risk care for infertile women, drawing on the TAPIC analytical framework (Transparency, Accountability, Participation, Integrity, and policy Capacity).
Background. As a reproductive health issue with major demographic dimensions, infertility has gained a prominent place on Iran's health-sector agenda over the past two decades, coinciding with a shift in national population policy toward raising fertility rates. Alongside this policy attention, growing evidence indicates that infertility itself, particularly ovulatory-disorder infertility such as polycystic ovary syndrome (PCOS), as well as assisted reproductive treatments, is associated with an increased risk of cardiovascular disease (CVD) later in life, a risk that has received limited attention within Iran's infertility control policies, which have mainly focused on expanding access and financial coverage for treatment.
Method. This study employed a document-based, directed qualitative content analysis of the international and national (Persian-language) peer-reviewed literature. Findings were categorized and analyzed across the five TAPIC domains. The study relies entirely on the review and analysis of existing texts and documents, without primary data collection or interviews.
Findings. The evidence indicates that Iran's infertility control policies face governance challenges across all five TAPIC domains regarding cardiovascular risk coverage for infertile women: limited transparency in recording infertile women's cardiovascular history within health information systems; unclear accountability between infertility and cardiology services; limited participation of cardiologists in the formulation of infertility guidelines; weak integration between cardiometabolic screening and infertility treatment pathways; and limited policy and infrastructural capacity for systematic cardiovascular risk screening in infertility clinics. Comparison with selected country experiences (including the UK's regulatory system and international PCOS guidelines) shows that integrating cardiovascular screening into infertility care pathways remains incomplete even in advanced health systems.
Conclusion. Strengthening the governance of Iran's infertility control policies requires the formal integration of cardiovascular screening and care into infertility service pathways, clearly defined accountability between infertility and cardiology services, the engagement of cardiologists in policymaking, and investment in workforce and information-system capacity-building.
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| Keywords: Health governance, TAPIC framework, Infertility, Cardiovascular risk, Health policy, Iran |
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Full-Text [PDF 864 kb]
(14 Downloads)
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: Research |
Subject:
Clinical nurses knowledge resources
Received: 2026/08/18 | Accepted: 2025/03/21 | Published: 2026/08/18 | ePublished: 2026/08/18
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