Differences and similarities in the attitudes of paediatricians, gynaecologists and experienced parents to criteria delineating potential risks for the welfare of children to be conceived with assisted reproduction

Summary

Question under study: Swiss legislation limits the provision of assisted reproductive medicine strictly to those infertile couples, who can guarantee the future welfare of their child. Daily practice often makes it difficult to balance between avoiding discrimination against infertile couples living in a borderline socio-economic or health situation on the one hand, and keeping to the stipulated maximal standards of future child welfare on the other. Obstetricians and neonatologists often criticise prior decisions made by physicians involved in reproductive medicine.

Methods: Based on existing regulations about child welfare and on experts’ opinions, thirteen hypothetical criteria for future well-being of children were formulated. These were presented to and assessed by 20 residents in obstetrics and gynaecology, 21 residents in paediatrics and 26 previously infertile couples having had children with the help of assisted reproduction.

Results: Although some criteria were rated more important than others, evaluation of the assessments did not reveal any statistically significant difference among the three assessing groups.

Conclusions: The lack of differences in the assessments of the hypothetical criteria among the three assessing groups related to the large variation in judgment among the various participants in each group, not to the acceptance or rejection of some of the criteria. The difficulty in defining applicable criteria for future child welfare is emphasised. A more individualised approach in the assessment of infertile couples is needed and must be implemented in the legal regulations.