Infertilty - call for regulation

The Women's Health Council (WHC) has called on the Governement to regulate infertility treatment and to implement the 2005 Commission on Assisted Human Reproduction report.

It has also called for more support for women undergoing the trauma of infertility.

Launching two new reports on infertility, the WHC pointed out that Ireland has no official body or legislation for the regulation and licensing of clinics offering IVF or other assisted reproduction technologies despite their presence in this country since the late 1980s.

The reports show that there are 10 clinics operating in Ireland at present providing infertility treatment, but only six of them are members of the European Society of Human Reproduction and Embryology reporting system, and only one provides NaPro (Natural Procreative Technology) treatment.

IVF, the most common form of infertility treatment in Ireland, costs around €4,000 for one cycle and intra-uterine insemination (IUI) is around €800.

Using egg donation can cost between €5,000 and €10,000. In addiiton, fertillty drugs, which are commonly used with these procedures, can cost up to €3,000 depending on how a woman responds to treatment.

Patients who cannot meet these costs have limited access to fertility treatments, the WHC says.

The WHC says infertility has been ranked as one of the great stressors in life, comparable to divorce or a death in  the family.

It says infertility affects one in six couples in Ireland and the use of assisted reproduction techniques has increased significantly in recent years.

The number of babies born as a result of IVF has more than doubled from 135 in 2000 to 301 in 2005.

According to the WHC, the demand for advice and treatment for fertility problems is also likely to increase over the coming years because of the trend to delay parenthood to pursue career or financial security, and an increase in obesity and sexually transmitted infections.

In terms of effectiveness of infertility treatments, the most recent figures show that the percentage of deliveries per IVF cycle is 21.1%, for a fresh cycle and 11.3% for a frozen cycle, which is in line with European figures.

According to the WMC, success is dependent on many factors, including patient age, weight and pregnancy history, and variations in IVF procedures such as the number of embryos transferred and the method of embryo transfer.

Maternal age is considered the most important determinant of conception, and much attention has been given to the increasing age of first-time mothers.

The WHC has stressed, however, that only an increased commitment to gender equality and family-friendly policies at work will encourage women to start trying to conceive at a younger age.

Its reports also point to the negative effect of infertility on women's lives.

"Women in infertile couples have been found to have lower self-esteem, to be more depressed, report lower life satisfaction and be more likely to blame themselves for their infertility than their male counterparts."

The reports show that that unsuccessful treatment is strongly associated with depression, anxiety, anger, helplessness, increased marital relationship tensions, grief and isolation.

One of the factors that appears to aggravate the effects of fertility treatment is the lack of a clear endpoint.

The WHC says research shows that the most common reason for ending treatment is psychological distress, while finances and medical reasons are usually secondary considerations, and many people also have unrealistic expectations of their chances of success.

The WHC notes notes that because of the link between assisted reproduction and multiple births, a multiple birth often exposes couples to unwanted speculation and intrusive questions about their fertility status and their children's conception, compounding existing levels of stress.

The WHC has called for increased availability of information on infertility treatments, increased attention to psychological and social issues during treatment and adoption of a couple-centred approach to treatment.

According to Geraldine Luddy, Director of the WHC, as a society, we need to be more aware of the issue of infertility and become more sensitive towards it.

"Infertility can cause a major disruption in people's lives because it interferes with people's desires and cultural expectations."

She said infertility can have substantial physical, social and emotional repercussions, especially for women who undergo the majority of invasive investigations and procedures regardless of the cause of infertility.

The reports can be viewed at www.whc.ie

 

 

[Posted: Thu 24/09/2009]


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