Assisted Conception: Health Services and Evaluation

Abstract

Comparison of assisted conception in Australia, the United Kingdom, and the United States indicates that further rapid growth in services is likely in many countries. Better data on pregnancy rates and the outcome of pregnancy, as well as standardized reporting of national results, are needed to monitor the effectiveness of treatment.

Psychosocial outcomes for parents and children after in vitro fertilization: A review

“…Second, anxiety may derive from the fact that IVF pregnancies are associated with higher rates of fetal loss, premature delivery, low birthweight, perinatal morbidity and caesarean birth for both single and multiple pregnancies (Saunders and Lancaster, 1989;Lancaster, 1991;Wennerholm et al, 1991;Brandes et a l , 1992;Doyle et al, 1992;Halasz et a l , 1993;Rufat et al, 1994). This juxtaposition of high investment and high risk creates anxiety during pregnancy which may, in turn, influence pregnancy risk and psychological adjustment.…”

“…The documented high incidence of perinatal morbidity in IVF births has raised concerns about possible adverse effects of IVF procedures on the development of the Psychosocial outcomesfor parents and chiLdren afier in vitro fertilization 1 1 children (Lancaster, 1991). In addition, concerns about the psychological adjustment of parents conceiving by IVF become translated into concerns about the quality of the rearing environment these parents are able to provide for their children (Weaver et al, 1993).…”

Viewpoint: Medical infertility care in low income countries: the case for concern in policy and practice

“…To arrive at a correct diagnosis and to treat patients safely and effectively, treatment centres need to have surgical (vaginal) ultrasound, specialized laboratory facilities and skilled, specialized providers. Effective treatment thus requires high investments translating into costly treatment, culminating in the case of ART where establishment of a unit, equipped according to international standard, costs between US$400 000 and 500 000 (Serour 1991; Lancaster 1991; Mor‐Yosef 1995; Okonofua 1996). Although patients in developing countries spend much money on different treatments (Inhorn 1994; Unisa 1999), the cost of assisted reproduction precludes its use for most who need it (Inhorn 1994; Hellum 1999).…”

“…Although there is evidence suggesting that many developing countries have facilities for assisted conception, the information that is made available is insufficient to determine the role of ART in terms of the number of clinics involved, the number of cycles and its effectiveness in these countries (Wang 1989; Olatunbosun et al . 1990; Lancaster 1991; WHO 1992; Inhorn 1994; Nwagfor 1994; Rojanasakul 1994; Anand Kumar 1996; Boonmongkon 1999; Hellum 1999; Okonofua 1999).…”

“…Remarkably, the reported number of 3 414 cycles in the Netherlands was, in fact, 12 500. The dearth of information on infertility treatment practices is worrying considering that the number of private for‐profit units has increased dramatically in recent years (Inhorn 1999) and that networks of units have been set up (Lancaster 1991) which may be operated by pharmaceutical companies.…”