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Type: Journal article
Title: Assisted reproductive technologies: A systematic review of safety and effectiveness to inform disinvestment policy
Author: Watt, A.
Elshaug, A.
Willis, C.
Hiller, J.
Citation: Health Policy, 2011; 102(2-3):200-213
Publisher: Elsevier Sci Ireland Ltd
Issue Date: 2011
ISSN: 0168-8510
Statement of
Amber M. Watt, Adam G. Elshaug, Cameron D. Willis, Janet E. Hiller, for the ASTUTE Health Study Group
Abstract: OBJECTIVE: Health policy relating to assisted reproductive technologies (ART) has been variably informed by clinical evidence, social values, political and fiscal considerations. This systematic review examined key factors associated with specific benefits and harms of ART to inform the development of a model for generating policy recommendations within an Australian disinvestment research agenda. METHODS: Six databases were searched from 1994 to 2009. Included articles contained data on safety and/or effectiveness of in vitro fertilisation (IVF) or IVF with intracytoplasmic sperm injection with reference to female age, male age or cycle rank. Narrative descriptions of key outcomes (live birth, miscarriage) were constructed alongside tabular summaries. RESULTS: Sixty-eight studies and one registry report were included. There was substantial heterogeneity present within the evidence-base which limited the strength and scope of conclusions that could be drawn. However, this review does affirm the differential effectiveness associated with the ageing of ART patients with regard to live birth and miscarriage. CONCLUSION: From the available evidence, it was not possible to determine an explicit age or cycle rank that could be used to formulate defensible policy responsive to identified differential effectiveness. Stakeholder interpretation of this evidence-base may assist in developing policy that can incorporate uncertainty and reflect social values.
Keywords: Review, systematic; Reproductive techniques, assisted; Health policy; Disinvestment
Rights: Copyright © 2011 Elsevier Ireland Ltd.
RMID: 0020113474
DOI: 10.1016/j.healthpol.2011.07.007
Appears in Collections:Public Health publications

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