Controversial issues in in vitro fertilization

Abstract

Although in vitro fertilization (IVF) has now become an accepted treatment for infertility, there are still several controversial issues in its application [ 1 Stephenson P.A. Wagner M.G. WHO recommendations for IVF do they fit with `Health for All'?. Lancet. 1993; i: 1648-1649 Abstract Scopus (6) Google Scholar ]. It has been argued by World Health Organization authorities that IVF benefits only a small proportion of infertile couples, that it is expensive and that it has serious health risks [ 2 Wagner M.G. St Clair P.A. Are in vitro fertilisation and embryo transfer of benefit to all?. Lancet. 1989; ii: 1027-1030 Abstract Scopus (49) Google Scholar ]. In a WHO report from the Regional Office for Europe it was suggested that eligibility for IVF should be limited to women under 40 years of age, and that the number of treatment cycles per woman should be limited [ 3 Consultation on the place of in vitro fertilisation in infertility care. Copenhagen: Regional Office for Europe, World Health Organization 1990. Google Scholar ]. The increased incidence of triplet and higher-order pregnancies caused by ovulation induction and assisted reproductive technologies (ART), its associated increased medical risks and high costs have been reported. This critical approach stresses the need for IVF programmes to raise their level of accountability.