Regulation of assisted reproductive technologies in the United States

Abstract

The regulation of any social activity is a complex activity, and perhaps this is no more so than in medicine where the interests of patients, profes sionals, society, and government can be in conflict. A special area of regula tory concern involves assisted reproductive technologies (ART), which are medical procedures involving the laboratory manipulation of gametes (sperm and eggs). In vitro fertilization (IVF) is the most commonly performed ART, whereas other technologies include intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis/screening (PGD/S) and assisted hatching (AH). The use of donor eggs (oocytes) and surrogates (gestational carrier, host uterus) are also considered ART procedures. Donor insemina tion (DI) by itself is generally not considered an ART procedure. Somatic cell nuclear transfer (SCNT) or "cloning" has been classified into thera peutic cloning or the use of SCNT to produce cells and tissues that can be used to treat disease, and is considered appropriate by many people, and reproductive cloning, the use of SCNT to create a genetically "identical" individual, which is considered an inappropriate use of technology by almost everyone. ART technologies are also used to create stem cells for both research and potential therapeutic purposes. Why should these technologies be regulated, what should be regulated, how should it be done, and who should be responsible? These are difficult questions that have been answered differently in many countries and by