Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion

Ethics Committee of the American Society for Reproductive Medicine

doi:10.1016/j.fertnstert.2019.01.033

Fertility and sterility, 2019

Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion

Ethics Committee of the American Society for Reproductive Medicine

Committee members: Judith Daar, Jean Benward, Lee Collins, Joseph Davis , Owen Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Susan Gitlin, William Hurd, Sigal Klipstein, Laurence McCullough, Richard Reindollar, Ginny Ryan, Mark Sauer, Sean Tipton, Lynn Westphal, Julianne Zweifel

DOI 10.1016/j.fertnstert.2019.01.033 PMID 30871767

Abstract

The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. In most cases, clear communication can avoid a direct conflict, but clinicians ethically may refuse to provide treatment believed to be futile or to carry a very poor prognosis. In certain instances, clinicians may provide limited treatment which they judge likely to be futile, but must be vigilant in their presentation of risks, benefits, and alternatives. This version replaces the previous published draft of this name (Fertil Steril 2012;98:e6-9).

Topics

Ethics and Policy: Reproductive Ethics ART Ethics
Clinical Guidelines and Standards: Guidelines by Issuing Body United States Professional Societies

Judith Daar, Jean Benward, Lee Collins, Joseph Davis, Owen Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Susan Gitlin, William Hurd, Sigal Klipstein, Laurence McCullough, Richard Reindollar, Ginny Ryan, Mark Sauer, Sean Tipton, Lynn Westphal, Julianne Zweifel, 0000-0003-0284-2845

J Daar, J Benward, L Collins, Joe Davis, Joey Davis, J Davis, O Davis, L Francis, E Gates, Liz Ginsburg, Beth Ginsburg, Betsy Ginsburg, E Ginsburg, Sue Gitlin, S Gitlin, Bill Hurd, Will Hurd, Billy Hurd, W Hurd, S Klipstein, Larry McCullough, L McCullough, Rick Reindollar, Dick Reindollar, Rich Reindollar, R Reindollar, G Ryan, M Sauer, S Tipton, L Westphal, J Zweifel

PMID 30871767 30871767 DOI 10.1016/j.fertnstert.2019.01.033 10.1016/j.fertnstert.2019.01.033 Ethics Committee of the American Society for Reproductive Medicine et al. 2019, Ethics Committee of the American Society for Reproductive Medicine 2019

Cite this article

Ethics Committee of the American Society for Reproductive Medicine (2019). Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion. Fertility and sterility. https://doi.org/10.1016/j.fertnstert.2019.01.033

Reproductive Ethics · ART Ethics

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion

Ethics Committee of the American Society for Reproductive Medicine, 2017 Fertility and sterility

Fertility programs may withhold services from prospective patients on the basis of well-grounded reasons that those patients will be unable to provide minimally adequate or safe care for offspring. This document was reviewed and updated; this version replaces the previous version of this document, last published July 2013 (Fertil Steril 2013;100:50-53).

Reproductive Ethics · ART Ethics

Disposition of unclaimed embryos: an Ethics Committee opinion

Ethics Committee of the American Society for Reproductive Medicine, 2021 Fertility and sterility

Programs should create and enforce written policies addressing the designation, retention, and disposal of unclaimed embryos. In the absence of program-specific policies, it is ethically permissible for a program or facility to consider embryos to have been unclaimed if a reasonable period of time has passed since contact with an individual or couple; efforts as outlined in the consent form have been made to contact the individual or couple; and no written instructions from the individual or couple with dispositional control exist concerning disposition. In such cases, programs or facilities may dispose of unclaimed embryos by removing them from storage and thawing without transfer. In the absence of specific written instructions, unclaimed embryos may not be donated to others for reproductive use or be used in research. This statement replaces the American Society for Reproductive Medicine Ethics Committee document "Disposition of Abandoned Embryos" published in 2013.

Reproductive Ethics · ART Ethics

The False Promise of Restorative Reproductive Medicine-Restricting Access to Care in the Name of "Natural" Medicine

Liao C et al., 2026 JAMA

Infertility affects 1 in 6 people globally (and up to a third of physicians) and is recognized by the World Health Organization and the American Medical Association as a disease. Since 1978, the development of assisted reproductive technology (ART), which is defined as fertility treatments in which gametes or embryos are handled in vitro, has made it possible to overcome otherwise insurmountable barriers to conception and has led to the birth of more than 10 million children worldwide.

Reproductive Ethics · ART Ethics

Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion

Ethics Committee of the American Society for Reproductive Medicine, 2018 Fertility and sterility

Clinicians should encourage disclosure between intimate partners but must maintain confidentiality in cases where there is no prospect of harm to the partner and/or offspring. In cases where one member of a couple refuses to disclose relevant health information to the other partner and there exists a risk of harm to the unaware partner and/or offspring, clinicians may refuse to offer care and should decline to treat if full informed consent is not possible due to lack of disclosure.

Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion

Abstract

Topics

Cite this article

Related articles

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion

Disposition of unclaimed embryos: an Ethics Committee opinion

The False Promise of Restorative Reproductive Medicine-Restricting Access to Care in the Name of "Natural" Medicine

Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion