TY - JOUR
T1 - Assisted reproductive technology in the USA
T2 - Is more regulation needed?
AU - Frith, Lucy
AU - Blyth, Eric
N1 - Funding Information:
Finally, the cost of such increased regulation might be seen as a barrier. In the UK, the HFEA is funded by a combination of government (Department of Health) funding, about £1.3m per annum, and fees levied on the clinics ( HFEA, 2012/13 ). Currently, clinics are charged £75 for each cycle of IVF they perform and £37.50 for donor insemination with a discount for elective SET (clinics are charged £75 for the first elective SET, after which no charge is made for all subsequent transfers (subject to a small number of exceptions). For every frozen embryo transfer that is not an elective SET, clinics are charged £75 ( HFEA, 2013b ). Most of the HFEA's costs are met by clinics paying this levy. In 2012–2013, fee income to the HFEA was £3,978,594, with a £778,476 grant from the Department of Health ( HFEA, 2012/13 ). It is important to note that most fertility treatment in the UK is carried out privately (40.3% of IVF treatment was funded by the National Health Service and 59.7% funded privately; with only 17.9% of donor insemination cycles funded by the National Health Service ( HFEA, 2013a )) and the cost per cycle is passed on to the consumer either as a specific item on the bill or as part of the general treatment fee. Therefore, in certain respects, the assisted reproductive technology treatment context in the UK and the USA are not as dissimilar as they are for other forms of medicine where, with certain exceptions, the bulk is publically funded in the UK. Any increase in regulation in the USA would incur some financial cost (both to the clinics and to the federal government), raising the cost of treatment, and there would need to be some federal commitment to providing funds to support such a national endeavour. We would argue, however, that this cost would be a small one, and the benefits of a well regulated and safe provision of assisted reproductive technologies would outweigh this.
Publisher Copyright:
© 2014 Reproductive Healthcare Ltd. All rights reserved.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - The regulation of assisted reproductive technologies is a contested area. Some jurisdictions, such as the UK and a number of Australian states, have comprehensive regulation of most aspects of assisted reproductive technologies; others, such as the USA, have taken a more piecemeal approach and rely on professional guidelines and the general regulation of medical practice to govern this area. It will be argued that such a laissez-faire approach is inadequate for regulating the complex area of assisted reproductive technologies. Two key examples, reducing multiple births and registers of donors and offspring, will be considered to illustrate the effects of the regulatory structure of assisted reproductive technologies in the USA on practice. It will be concluded that the regulatory structure in the USA fails to provide an adequate mechanism for ensuring the ethical and safe conduct of ART services, and that more comprehensive regulation is required.
AB - The regulation of assisted reproductive technologies is a contested area. Some jurisdictions, such as the UK and a number of Australian states, have comprehensive regulation of most aspects of assisted reproductive technologies; others, such as the USA, have taken a more piecemeal approach and rely on professional guidelines and the general regulation of medical practice to govern this area. It will be argued that such a laissez-faire approach is inadequate for regulating the complex area of assisted reproductive technologies. Two key examples, reducing multiple births and registers of donors and offspring, will be considered to illustrate the effects of the regulatory structure of assisted reproductive technologies in the USA on practice. It will be concluded that the regulatory structure in the USA fails to provide an adequate mechanism for ensuring the ethical and safe conduct of ART services, and that more comprehensive regulation is required.
KW - American Society for Reproductive Medicine (ASRM)
KW - assisted reproductive technologies
KW - infertility treatment
KW - legislation
KW - policy regulation
UR - http://www.scopus.com/inward/record.url?scp=84908139589&partnerID=8YFLogxK
U2 - 10.1016/j.rbmo.2014.06.018
DO - 10.1016/j.rbmo.2014.06.018
M3 - Article
C2 - 25171854
AN - SCOPUS:84908139589
SN - 1472-6483
VL - 29
SP - 516
EP - 523
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 4
ER -
