Are we exploiting the infertile couple?

Blackwell, Richard E.; Carr, Bruce R.; Chang, R. Jeffrey; DeCherney, A. H.; Haney, A.F.; Keye, William R.; Rebar, Robert W.; Rock, John A.; Rosenwaks, Z.; Seibel, Machelle M.

doi:10.1016/s0015-0282(16)59521-1

Cited by 46 publications

(17 citation statements)

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“…Because many cycles do not result in a live birth, the average cost per delivery is over $50,000 (Collins, 2001). In 1987, a group of leading endocrinologists published an article in the primary clinical journal in the field questioning whether existing credentialing mechanisms of ART providers were adequate, whether providers were performing ART on clinically appropriate patients, and whether providers were truthfully informing patients about their likely success with ART (Blackwell et al, 1987).…”

Section: Fertility Clinics and Quality Report Cardsmentioning

confidence: 99%

Do markets respond to quality information? The case of fertility clinics

Bundorf

Chun

Goda

et al. 2009

Journal of Health Economics

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Although policymakers have increasingly turned to provider report cards as a tool to improve health care quality, existing studies provide mixed evidence on whether they influence consumer choices. We examine the effects of providing consumers with quality information in the context of fertility clinics providing Assisted Reproductive Therapies (ART). We report three main findings. First, clinics with higher birth rates had larger market shares after the adoption of report cards relative to before. Second, clinics with a disproportionate share of young, relatively easy-to-treat patients had lower market shares after adoption versus before. This suggests that consumers take into account information on patient mix when evaluating clinic outcomes. Third, report cards had larger effects on consumers and clinics from states with ART insurance coverage mandates. We conclude that consumers respond to quality report cards when choosing among providers of ART.

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Section: Fertility Clinics and Quality Report Cardsmentioning

confidence: 99%

Do markets respond to quality information? The case of fertility clinics

Bundorf

Chun

Goda

et al. 2009

Journal of Health Economics

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“…Beyond a direct physiological impact, IVF adjuncts might also be of emotional and psychological benefit to patients during a time of intense vulnerability and desperation 9. Time-lapse imaging has revealed that embryos which undergo direct cleavage from one to three cells have a mere 1% chance of implanting, despite appearing morphologically normal at the blastocyst stage 20.…”

Section: Beneficencementioning

confidence: 99%

“…It is, therefore, possible that the financial burden imposed by adjunct IVF treatments robs present and future patients of their chance to access treatment and achieve their goal. Consequently, there is an unambiguous need to protect both individuals who might be vulnerable to emotional and financial exploitation,9 as well as entire patient groups and communities from unjust distribution of resources. It is paramount that conflicting financial interests, which might be tainting the infertility treatment industry,14 are abandoned in favour of rationally seeking out the most cost-effective option for different treatment circumstances and patient allowance.…”

Section: Non-maleficencementioning

confidence: 99%

“…This controversy was brought to public attention by an associated TV programme for investigative journalism—BBC One’s Panorama: Inside Britain’s Fertility Business, which portrayed the field of ART as a profit-oriented business, creating a sense of credibility gap between patients and their physicians. Despite the fact that the studies were not well accepted among leading specialists in the field,8 they raised valid concerns regarding the need to protect patients, who are particularly vulnerable during their struggle with infertility 9. In the UK, this has started a discussion about the need for new legislation to regulate adjunct IVF tools and the Human Fertilisation and Embryology Authority has been prompted to release official guidelines on the effectiveness and safety of commonly offered add-ons.…”

Section: Introductionmentioning

confidence: 99%

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Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Zemyarska

2019

J Med Ethics

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In vitro fertilisation (IVF) ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.

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“…The modem fertility clinic usually adopts a planned approach (Rowe & Farley, 1988). To make such a process as least stressful as possible, attention should primarily be given to providing suitable facilities for treating the couple and for giving them the necessary truthful information at every stage so that educated choices can be made about proposed diagnostic procedures or therapeutic options (Blackwell et al, 1987).…”

Section: Introductionmentioning

confidence: 99%