Marcia C. Inhorn, PhD, MPH and Pasquale Patrizio, MD, MBE
Low-cost in vitro fertilization (LCIVF) is better than no infertility treatment in countries that prohibit adoption and third-party reproductive assistance.
AMA J Ethics. 2018;20(3):228-237. doi:
10.1001/journalofethics.2018.20.3.ecas1-1803.
Federal regulations governing egg donation fall into two categories: safety testing and truth in advertising. Neither deals directly with informed consent by, for example, specifying what information donors must be given.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
When deciding whether to provide assisted reproductive services to a postmenopausal woman, the doctor must consider the well-being of the future child but not put social concerns above the individual patient's interests.
If the American Society for Reproductive Medicine's recommendations for egg-donor compensation limits have been successful, they violate antitrust law. If they are ineffective, egg donors are not being sufficiently protected against coercion and commodification.
To be best able to respond if third parties in assisted reproduction contracts break their terms, physicians should familiarize themselves with the contracts, encourage all parties to self-disclose, and, failing that, disclose material information to the other party.
This month, Virtual Mentor theme issue editor, Katie Falloon, a medical student at the Duke University School of Medicine, interviewed Dr. Thomas Price about the ethical and regulatory issues associated with assisted reproductive technologies (ART).