Revisiting selected ethical aspects of current clinical in vitro fertilization (IVF) practice

Anja von Schondorf-Gleicher, Lyka Mochizuki, Raoul Orvieto, Pasquale Patrizio, Arthur S. Caplan, Norbert Gleicher

Research output: Contribution to journalComment/debate

Abstract

Ethical considerations are central to all medicine though, likely, nowhere more essential than in the practice of reproductive endocrinology and infertility. Through in vitro fertilization (IVF), this is the only field in medicine involved in creating human life. IVF has, indeed, so far led to close to 10 million births worldwide. Yet, relating to substantial changes in clinical practice of IVF, the medical literature has remained surprisingly quiet over the last two decades. Major changes especially since 2010, however, call for an updated commentary. Three key changes deserve special notice: Starting out as a strictly medical service, IVF in recent years, in efforts to expand female reproductive lifespans in a process given the term “planned” oocyte cryopreservation, increasingly became more socially motivated. The IVF field also increasingly underwent industrialization and commoditization by outside financial interests. Finally, at least partially driven by industrialization and commoditization, so-called add-ons, the term describing mostly unvalidated tests and procedures added to IVF since 2010, have been held responsible for worldwide declines in fresh, non-donor live birthrates after IVF, to levels not seen since the mid-1990s. We here, therefore, do not offer a review of bioethical considerations regarding IVF as a fertility treatment, but attempt to point out ethical issues that arose because of major recent changes in clinical IVF practice.

Original languageEnglish
Pages (from-to)591-604
Number of pages14
JournalJournal of Assisted Reproduction and Genetics
Volume39
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • Add-ons to IVF
  • Cryopreservation
  • Egg freezing
  • Embryos
  • Ethics
  • Fertility preservation
  • Gametes
  • In vitro fertilization (IVF)
  • Oocytes
  • Preimplantation genetic testing for aneuploidy (PGT-a)

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