1/2012
vol. 93
abstract:
OPINIONS In vitro babies – medical and legal aspects:
a European and North American perspective
BioTechnologia vol. 93(1) C pp. 9-26 C 2012
Online publish date: 2014/10/28
PlumX metrics:
On the basis of observations in Europe and North America, this review will focus on Assisted Reproductive
Technologies (ART) and their impact on pregnancy outcomes; in particular multiple births, prematurity, and their
impact on birth defects. In Europe, since 1985 this experience has been somewhat different from that in North
America due not only to the differing populations, cultures, religious perspectives, but also to the rapid implementation
of medical technologies, relative freedom from governmental regulation, as well as the different forms of
payment for medical care that exist between the two continents. This review will focus on the impact of ART on
the complications of pregnancy, multiple gestations and prematurity, and will evaluate the required process and
content of informed consent surrounding ART from the legal perspective. Issues related to complications resulting
from the use of ART from the perspective of neonatal care providers will be highlighted as well as its impact
on the health care system in both regions. Given the impact of ART on both sides of the Atlantic, we propose that
governments, as well as professional organizations – including reproductive specialists, neonatologists, and health
economists – recommend that a legal limitation on the number of embryo transfers be imposed and that embryo
transfer restrictions be coupled with reimbursement for ART services. We suggest that reproductive rights should
not be infringed but that greater concern for and monitoring of the safety of both mothers and their newborns
be undertaken by various professional organizations and governments in Europe and North America. We also propose
systematic centralized reporting of the effectiveness of each form of ART, along with any associated complications,
and that ART babies be carefully monitored for birth defects and imprinting disorders on both continents.
keywords:
Assisted Reproduction Technologies (ART), prematurity, multiple gestation, imprinting disorders,
birth defects, newborn safety, congenital malformation, ART outcomes
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