P-348 Assisted Reproduction Legislation: Listening to the voice of Health Care Professionals

Abstract

Abstract Study question To investigate the perceptions of health care practitioners in Ireland to a draft Assisted Human Reproduction (AHR) Bill, currently being assess by government. Summary answer There is strong support for AHR and for national legislation in this field among healthcare professionals working in Ireland. What is known already AHR legislation is essential to protect the rights of those accessing, born from and providing AHR services. Ireland is one of the only countries in the EU which lacks specific AHR legislation. The General Scheme of an AHR Bill was published in 2017 and is currently awaiting review and approval by government. Study design, size, duration An anonymous 25-item questionnaire was distributed via secure email link. This was a detailed 5-point Likert Scale questionnaire based on clinically relevant aspects of the Irish draft AHR Bill. Consultants and trainees in Obstetrics and Gynaecology were identified through The Institute of Obstetricians and Gynaecologists. A snow balling approach was used to recruit General Practitioners and all Fertility Clinics in Ireland were asked to distribute the questionnaire to their staff. The study remained open for 28days. Participants/materials, setting, methods Participants included Consultant and trainee Obstetrician Gynaecologists, general practitioners and multidisciplinary staff at Irish fertility clinics. The questionnaire focused on six key factors; a national AHR regulatory authority, AHR treatment type and availability, age limits for AHR treatment, counselling prior to ART, posthumous use of gametes and embryos and legislations surrounding surrogacy. Main results and the role of chance In total 245 responses were received. The majority of respondents were female aged 31-59years. 42.2% (n = 103/244) are currently working or had previous experience working with ART. 93% (n = 215/231) of respondents believe that Ireland should have a national authority to regulate AHR – similar to the Human Fertilisation and Embryology Authority (HFEA) in the UK. Over 80% of participants strongly agreed with access to IVF and gamete and embryo vitrification being available in Ireland. The majority of participants also supported oocyte and sperm donation (69% and 71% respectively). Support for more recent technologies in AHR was variable. Over 50% of respondents strongly disagreed with sex selection for non-medical reasons and less than half of participants strongly agreed with ART for single men and transgender males/females. 80.5% (n = 170/211) of respondents felt that there should be an upper age limit for women receiving access to ART and 64.5% (n = 136/211) felt there should be an upper age limit for men. Those who had experience working in an AHR clinic felt more strongly that sperm / egg donors should be paid a modest fee for donation (p = 0.04; p = 0.03 respectively) and that counselling should be mandatory for every person considering gamete donation (p = 0.0233). Limitations, reasons for caution Due to reliance on third parties in distribution of the survey to target groups, a response rate could not be calculated, a limitation of the study. A further limitation is the high detail of the survey questions, which seemed to lead to participant fatigue with later questions. Wider implications of the findings National legislation on AHR is both needed and desired by health care professionals working in Ireland. It is hoped that results of this study will help inform the proposed national AHR legislation as it nears completion and in turn, elevate Irelands low position in the European Atlas of Fertility Policies. Trial registration number not applicable