Human Reproduction, Vol 13, 766-770, Copyright © 1998 by Oxford University Press
JC Patel and MH Johnson
Seventy-one clinics in the UK offering in-vitro fertilization (IVF)
treatment were surveyed for their protocols on the assessment of the
welfare of the children produced. A total of 44 (62%) responded. Of these,
five (12%) did not have operational protocols, seven (16%) declined to
provide their protocols, and 32 (73%) provided information used in the
survey. The information was in the form of a protocol for only 16 (50%) of
these clinics. The remaining clinics submitted as their 'protocols' letters
to general practitioners, patient information, patient questionnaires
and/or a copy of their policy on the assessment of child welfare. From the
submitted material, it was possible to determine that 94% of clinics seek
information on aspects of child welfare assessment, 78% have a procedure
for making further enquiries where there is any cause for concern, 44 %
include counselling opportunities explicitly in protocols, 30-38% of
clinics see a full medical and social history from each prospective parent
as part of the child welfare assessment, 16% include explicit consideration
of the impact of multiple births on the welfare of the child, and 3%
include consideration of the issue of disclosure of the mode of conception
of the child on its welfare. Most clinics did not have clearly defined
procedures on how to reach a decision on whether or not to treat. Eight
clinics (25%) made explicit in their protocols any exclusion criteria. It
is concluded that clinics are not currently producing completely effective
protocols. Two possible reasons for this are considered: lack of technical
knowledge about what constitutes an effective protocol, and lack of clear
policy development and propagation underlying protocols within clinics.
Possible approaches to improving the situation are considered.
ARTICLES
A survey of the effectiveness of the assessment of the welfare of the child in UK in-vitro fertilization units
Department of Anatomy, Cambridge, UK.
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