Artificial intelligence (AI) refers to the development of algorithms, processes, machines, and computer programs capable of performing automated tasks, without the programming of each step explicitly by a human [1,2]. Advances in computing processing combined with the amassing of data through digital tools, particularly with increases in the penetration of mobile devices, have propelled the field of AI within health [3-6]. AI includes approaches such as machine learning, in which statistical and mathematical modeling techniques are used to define and analyze data. This can also be applied through natural language processing to analyze text-based data and signal processing for audio, images, and videos [6,7]. The use of AI varies across health fields, with radiology and pathology being the dominant areas where machine learning has been leveraged to optimize the processing of large volumes of medical imaging data [6,7]. Recent advancements in AI, particularly generative AI and large language models, have expanded the ability to address a diverse set of health needs.

The field of sexual and reproductive health encompasses health domains, such as family planning and fertility care, maternal health, sexually transmitted infections (STIs), safe abortion care, sexual health and well-being, and gender-based violence [8,9]. It is underpinned by broader principles of bodily autonomy, human rights, women’s empowerment, and gender equality, encapsulated as sexual and reproductive health and rights (SRHR) [10]. Considering the perceived sensitivity and often politicization of these health topics beyond the influence of technology, the use of AI in SRHR is an emerging area with both great potential and justifiable concerns. Individuals’ desires for anonymity in seeking sexual and reproductive health services positions AI systems and tools, such as conversational agents, as critical conduits for expanding access to information and care [11-13]. Furthermore, shortfalls in human resources and the need for targeted health interventions, such as in the areas of maternal health care and management of STIs, serve as key issues that have the potential to be addressed through the predictive capabilities offered by AI [14]. In addition, the use of AI to power “software as a medical device” [15] presents an opportunity to leapfrog access to diagnostic devices, such as ultrasounds [16] and blood pressure equipment [17]. This has also been seen with the emergence of contraceptive and fertility software applications [18,19], which are increasingly securing regulatory approvals from national authorities [20,21].

The convergence of AI in SRHR also presents heightened risks and implications. This is especially evident as the use of underlying health data raises concerns about infringements on women’s health and bodily autonomy, as well as the potential misuse of this technology for surveillance of populations in vulnerable situations. Furthermore, existing challenges in digital health implementation [22], including biases, limited inclusivity, and gender disparities, could be exacerbated with the introduction of AI [6,23-25]. As such, the intersection of AI and SRHR raises nuanced implications and warrants close examination of the current landscape to highlight the evidence base and document the ethical, regulatory, and human rights considerations. This scoping review will build on the general literature of AI in health and focus specifically on how AI is being used within SRHR, including evidence on effect and related considerations to inform a comprehensive understanding of the state of the field.

The database searches described above resulted in 12,793 records when the searches were conducted in October 2023. Screening is underway, and the analysis is expected to be completed by July 2024.

Building on the broader literature on AI and health, findings from this review will provide fundamental insights into the usage patterns, implications, and evidence related to AI in SRHR, as well as highlight key considerations and risks. A key strength of this review is the composition of a multidisciplinary authorship team to ensure both the technological and SRHR perspectives are appropriately reflected. Moreover, this scoping review serves as a foundational resource to inform a technical brief developed by the World Health Organization [38] and to guide future research and practice. One limitation of this review is its focus on empirical studies, in which insights from the gray literature and AI consumer products may be overlooked if they are not reflected in the peer-reviewed literature. However, due to the high number of records in the search, we believe this scoping review can reliably provide a comprehensive overview of usage patterns and key implications.

The intersection of AI and SRHR has been fraught with concerns, particularly related to infringements on women’s reproductive health choices and the exacerbation of gender biases and inequity [39]. Meanwhile, technological advances hold great promise for overcoming longstanding challenges in access to and provision of SRHR services. This systematic analysis of AI in SRHR seeks to facilitate clarity and nuanced discussion in this highly charged field and direct efforts toward responsibly and meaningfully harnessing of AI to address SRHR needs and the broader goals of universal health coverage.