Ethical and Cultural Challenges in Global Impementation of Assisted Reproduction Technology(ART)- An Integrative Literature Review of the Middle East and Africa

Abstract

This thesis explores the ethical and cultural challenges influencing the implementation and acceptance of Assisted Reproductive Technology (ART) in the Middle East and Africa. The aim of this thesis is to assist stakeholders in reproductive health, such as medical professionals, legislators, and religious leaders, in creating ART policies that are fair and culturally aware. The main development task is to investigate the legal frameworks and socio-religious barriers that influence ART accessibility in order to produce evidence-based suggestions for the creation of morally sound and inclusive policies. By combining the concepts of sociocultural anthropology, religious ethics, and bioethics (autonomy, beneficence, non-maleficence, & justice), the theoretical framework offers a multidisciplinary perspective for evaluating the contentious landscape of ART.

Using the PEO (population, exposure and outcome) framework, the study conducted a systematic evaluation of fourteen (14) peer-reviewed studies published between 2015 and 2025 using the Integrative Literature review (ILR) technique in order to identify exposures and outcomes that are specific to a given population. The main conclusions highlight four main issues: (1) social injustice in access to ART because of financial and legal disparities; (2) cultural and gendered burdens that stigmatise infertility and restrict reproductive autonomy; (3) internalised psychological distress linked to moral and religious pressures; and (4) disjointed or non-existent ART governance structures across nations. Both Islamic and Christian religious beliefs severely limit third-party reproductive aid (such as gamete donation and surrogacy), which affects country laws and public opinion. ART use is further restricted by cultural norms surrounding marriage fidelity, lineage, and conventional family structures, which frequently marginalise women and those with lower incomes.

According to the study, the use of ART in these areas is intricately linked to cultural, religious, and ethical values, and universal biomedical criteria are insufficient in the absence of contextual adaptation. Regulatory fragmentation and moral gatekeeping directly lead to policy stagnation, reproductive tourism, and exploitation in unregulated ART marketplaces. The study suggests that in order to overcome these obstacles, inclusive ART policies should be developed through cross-sectoral cooperation with religious leaders, enhanced legal supervision, public education to lessen stigma, and subsidised ART services to improve equity.