Tough Choices: In Vitro Fertilization and the Reproductive Technologies (Health, Society, and Policy) by Patricia Stephenson (Editor), Marsden G. Wagner (Editor) Purchase at:  Amazon.com  Format: Hardcover, 192pp.  ISBN: 1566390605 Publisher: Temple University Press  Pub. Date: September 1994

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From the Publisher

In vitro fertilization (IVF), gamete intra-fallopian transfer (GIFT), and other technologies of assisted conception have been heralded by the medical community and the media as "the answer" for infertile couples. This timely collection of articles discusses medical and social options for couples facing infertility; the effectiveness, safety, costs, and benefits of the new reproductive technologies; and some of the legal and ethical issues surrounding the use of these services. Although now in widespread use, the new reproductive technologies have not yet been fully evaluated. No attempts have been made to determine the need for such services, to compare their effectiveness with other therapies to restore fertility, or to assess the risks associated with such treatments. Since there is no agreed-upon standard definition of infertility, over-diagnosis is often spurred by exaggerated claims of success by medical sources and the media. Over-treatment exposes women to unnecessary risks and has a staggering impact on national health budgets. Bringing together key issues in health policy analysis, this volume argues for a public health approach to infertility, maintaining that far too little attention has been given to the important social, ethical, and legal issues involved. These internationally focused essays address critical issues that have arisen from the proliferation of infertility technologies: Should there be any social criteria for IVF recipients? Does society have a responsibility to deal with the long-term consequences of the technology? What is to be done about the diversion of money, resources, and health professionals' talents away from pressing community health needs into a high technology benefiting only a few? What are the best ways to handle ethically questionable practices such as inducements to women to donate their eggs to IVF clinics and misrepresentation of success rates?

Table of Contents

Preface

Introduction: Infertility and In Vitro Fertilization: Is the Tail Wagging the Dog?    1

1 Medically Assisted Conception: The State of the Art in Clinical Practice   25

2 Social Alternatives to Infertility   37

3 Technology Assessment and Infertility Care   53

4 The Effectiveness of In Vitro Fertilization: An Epidemiological Perspective   62

5 The Financial Costs of In Vitro Fertilization: An Example from Australia   73

6 Health Services for Infertility: A Cost-Effectiveness Analysis from the Netherlands   83

7 Ovulation Induction During Treatment of Infertility: An Assessment of the Risks   97

8 Physiological and Psychosocial Risks of the New Reproductive Technologies   122

9 The Neonatologist's Experience of In Vitro Fertilization Risks   135

10 Some Legal Aspects of Modern Reproductive Technology   147

11 Equity and Resource Distribution in Infertility Care   161

About the Contributors   167