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The effectiveness of assisted reproductive technologies: a literature review

Assisted reproductive technologies: a literature reviewA systematic review of studies on the outcomes of assisted reproductive technologies raises some troubling questions for governments that use public funds to pay for these technologies.

 

 

This research was conducted for the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services. A total of 478 studies, representing a variety of different countries, met the selection criteria. Only articles published in English were considered.

 

The goal of this literature review was to answer the following three questions:

  1. Ovulation inductionWhat are the outcomes of interventions used in ovulation induction and superovulation (the production of extra eggs) in terms of pregnancy, live birth, multiple gestation and complications?
     

  2. Multiple gestationWhat are the outcomes of interventions used in assisted reproductive technologies in terms of pregnancy, live birth, multiple gestation and complications?
     

  3. Low birth weightWhat are the longer-term outcomes for the fetus/child in terms of spontaneous abortion, ectopic pregnancy, preterm delivery, low birth weight, and neonatal and infant complications, and for the mother in terms of pregnancy complications, cancer and psychological/emotional problems?
     

 

The report presents some interesting findings. For example, infertility itself could be associated with adverse longer-term outcomes for children born following infertility treatment; this could be due to maternal and paternal characteristics, including low fertility. In the mother, infertility, but not infertility treatment, could be linked to an increased risk of breast and ovarian cancer. In addition to presenting findings of a technical nature (for example, concerning the comparative effectiveness of different methods being used to accomplish the same step), the report points to a major problem with the studies themselves. Insufficient evidence to draw conclusions, a lack of comparability due to success being measured in different ways between studies, and poor methodological quality are some of the problems that make it difficult to accurately evaluate existing practices and techniques. With increasing demands being made on the public purse to support access to these technologies, there will be increasing pressure to demonstrate their effectiveness.

 

 

Author : Geneviève Daudelin, Ph.D.

 

 

RÉFÉRENCES

  • Myers ER, McCrory DC, Mills AA, Price TM, Swamy GK, Tantibhedhyangkul J, Wu JM, Matchar DB. Effectiveness of Assisted Reproductive Technology. Evidence Report/Technology Assessment No. 167 (Prepared by the Duke University Evidence based Practice Center under Contract No. 290 02 0025.). AHRQ Publication No. 08 E012. Rockville, MD: Agency for Healthcare Research and Quality. May 2008.

 

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