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Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)


KEY POINTS

  • Financial ‘‘risk-sharing’’ programs offer patients a payment structure under which they pay a higher initial fee but provide reduced fees for subsequent cycles and may receive a refund if they do not become pregnant or deliver a baby. These programs also may offer financing of in vitro fertilization (IVF) costs.
  • Financial ‘‘risk-sharing’’ programs present a potential conflict of interest between the patient's desire to become pregnant without compromising their financial ability to pursue other methods of becoming a parent, such as adoption, and the provider's financial interests.
  • Financial ‘‘risk-sharing’’ programs may be ethically acceptable if they are practiced under certain carefully limited guidelines:
    • Criteria for program inclusion and termination must be clearly specified.
    • Patients must be fully informed of the financial costs, advantages and disadvantages of the programs and available alternatives. Participants must be clearly informed of their chances of success if found eligible for the financial ‘‘risk-sharing’’ program, and must be informed that the program is not guaranteeing pregnancy and/or delivery.
    • Programs must adhere to all ASRM practice guidelines with respect to ovarian stimulation, number of embryos to transfer, and ancillary procedures and must not take medically inappropriate risks in order to increase the likelihood of achieving a pregnancy.
Some assisted reproduction programs now offer IVF on a financial ‘‘risk-sharing,’’ ‘‘warranty,’’ ‘‘refund,’’ or ‘‘outcome’’ basis, in addition to traditional fee-for-service pricing. Initially, financial ‘‘risk-sharing’’ patients pay a higher fee. If a ‘‘risk-sharing’’ patient has an ongoing pregnancy or delivery (depending on the structure of the program), the provider keeps the entire fee. If treatment fails, however, the patient may be entitled to additional IVF cycles following which, if unsuccessful, a specified percentage of the fee is returned to the patient. Pretreatment screening and medication costs, both of which can be considerable, are ordinarily not covered in these plans. These programs often offer patients the chance to finance the cost of the program fees with variable interest rates.

Such programs have been criticized as being exploitative, misleading, and contrary to long-standing professional norms against charging contingent fees for medical services. Proponents, on the other hand, argue that this form of payment is a legitimate response to the lack of health insurance coverage for IVF and to patient concerns about the high cost and substantial risk of IVF failure. Only 15 states currently have laws that mandate insurance coverage for fertility care, and only six states mandate coverage that includes IVF (1). Patients who are not covered by insurance may bear the entire cost of IVF out of pocket, which can exceed 50% of their disposable income (2). In effect, the higher initial fee to enter a financial ‘‘risk-sharing’’ program cross-subsidizes the refunds for patients who are unsuccessful. Although little published literature is available, at least one company managing a financial ‘‘risk-sharing’’ program reported that 20% of participants received refunds due to not achieving a pregnancy (3).

Focusing on the positive impact on patients, financial ‘‘risk-sharing’’ plans may serve as a form of insurance against the risk of catastrophic costs associated with failure of IVF and might appeal to couples who would wish to recuperate financial resources in order to attempt other methods of becoming parents, such as adoption or third-party reproduction, should IVF prove unsuccessful (4). Clinics must make efforts to accurately describe the details of the program to patients before enrollment. Results from one study, however, suggest that fertility clinics frequently do not disclose these criteria or the benefits and detriments of participation, with one author recommending that more oversight may be needed to ensure ethical administration of these programs (5). In structuring a financial ‘‘risk-sharing’’ program, providers must strive to ensure that potential profit motives do not inappropriately affect the care that is provided. Transparency about success rates and adherence to standard stimulation protocols, including the number of embryos to transfer, aids in this endeavor.


ETHICAL ANALYSIS

The ethical acceptability of these plans must be judged by their impact on patients and not on the profit motive or entrepreneurial impulse that also may have motivated their emergence. Financial ‘‘risk-sharing’’ programs are likely to appeal to, and are most often only available to, patients who must self-pay for IVF, thus taking on the financial ‘‘risk-sharing’’ role of health insurance plans. In exchange for a higher initial fee compared to the cost of one IVF cycle, financial ‘‘risksharing’’ programs agree to provide up to a specified number of IVF cycles to eligible patients. If IVF is successful before the agreed-upon number of cycles is reached, the clinic keeps the entire amount of the fee. If no pregnancy or delivery occurs within a certain number of embryo transfers or in a specified amount of time, the patient receives a refund of all or a specified percentage of the fee (exclusive of screening and medication costs) (6). The higher initial fee is intended to cover the cost of refunds to unsuccessful patients; however, in some situations, even if patients become pregnant before the program is complete, the cost of their financial ‘‘risk-sharing’’ program is comparable to the costs they would have incurred if paying for each IVF cycle individually, depending on how the fees are structured.

One ethical concern raised about financial ‘‘risksharing’’ programs is that they are misleading or exploitative in that they have the potential to coerce patients who are desperate to have a child into purchasing a more expensive form of IVF service than is necessary. In order to meet this concern, programs must be careful to ensure that patients who are offered the financial ‘‘risk-sharing’’ option are suitable candidates for it. Patients must be made fully aware of the specific costs, advantages, and disadvantages of the programs, must be clearly informed of their chance of success at that clinic and its criteria for refund or exclusion of refund, and must be informed that the program is not guaranteeing pregnancy and/or delivery. Patients should be counseled about alternatives to financial ‘‘risk-sharing’’ programs, including undergoing IVF without enrolling in the program (fee for service) and the decision not to undergo IVF. It is especially important for patients to have as clear an understanding as possible about their own per cycle chances of success so that they are not induced to purchase services that are more expensive than necessary. Equally, patients who meet program qualifications for these plans should know whether they are otherwise good candidates for successful IVF and thus might not need to purchase this form of service. Patients also should understand that clinics may have different records of success for different types of patients. Although it should be noted that there are difficulties in comparing clinics in terms of efficacy, these difficulties exist independently of financial arrangements such as financial ‘‘shared-risk’’ programs. It is reasonable to provide consultation with financial counselors prior to participation in financial ‘‘risk-sharing’’ programs to ensure that the cost structure is understandable to the patients, and if patients are traveling to the United States for their care from another country, that it is clear in what currency the fees are to be paid.

A second ethical concern has arisen because financial ‘‘risk-sharing’’ programs appear to violate long-standing ethical prohibitions against paying contingency fees in medicine. This concern is based on Opinion 6.01 of the American Medical Association (AMA) Code of Medical Ethics, which states that ‘‘a physician's fee should not be made contingent on the successful outcome of medical treatment’’ (7). However, neither of the following two reasons given in support of Opinion 6.01 applies to IVF financial ‘‘risk-sharing’’ plans that are appropriately structured.

The first reason relates to doctors making their professional fees contingent on the success of a patient's pending medical malpractice or worker's compensation claim, thereby potentially skewing the medical opinion that they render in such a case (8). But this concern has no bearing on the propriety of financial ‘‘risk-sharing’’ plans for IVF services, for they make fees contingent on the outcome of the treatment itself, not on the outcome of a lawsuit.

The second reason cited in support of Opinion 6.01 is that hinging fees on the success of medical treatment implies that ‘‘successful outcomes from treatment are guaranteed, thus creating unrealistic expectations of medicine and false promises to consumers.’’ While it is unethical to create unrealistic expectations or make false promises, financial ‘‘risk-sharing’’ plans do not appear to have that intent or effect. Providers charge a substantial premium to those who enter the plan, compared with their conventional fee-for-service charge. While the provider's willingness to assume some of the risk of failure may convey a message of confidence in its services, patients should be appropriately counseled not to regard the arrangement as a guarantee of success. On the contrary, the ‘‘premium’’ built into financial ‘‘risk-sharing’’ fees signals to the patient that the provider needs to be compensated for assuming some of the risk of failure precisely because there is a significant risk that treatment will fail. What is guaranteed is not success, but a potential refund if treatment fails. Moreover, when the fee structures of programs are aimed to offset the costs of failure (refunds) by the increased initial charge (retained by the clinic in case of success), patients are in effect serving as an insurance pool. The program permits patients the additional option of recovering some of what they have paid if they are unsuccessful so that they may pursue other options.

Another rationale not mentioned in Opinion 6.01 that might justify an ethical objection to contingent fees in medicine is that it is often hard to define medical success and determine whether it has occurred in a given case. Where the measure of success is not clearly specifiable, contingent fees will inevitably spawn doctor-patient disputes over whether a fee has been earned. This concern may be obviated, however, if financial ‘‘risk-sharing’’ plans clearly specify measures of success, either delivery of a child or a pregnancy of specified duration. These measures, however, must not be specified in a manner that encourages inappropriate medical practices, such as embryo transfers that do not meet practice guidelines (8).

A third set of concerns is that such programs have a builtin potential conflict of interest that is likely to skew clinical decision making toward achieving pregnancy regardless of the impact on the patient in order to avoid paying a refund. Two such dangers may be cited. One is that the provider will be biased in favor of stimulation protocols that tend to produce more oocytes and pose increased risks to the woman's health. The other is that the provider will be biased in favor of transferring a relatively large number of embryos, thereby increasing the likelihood not only of pregnancy but of multiple gestations, which can harm women, fetuses, and potential offspring. On the other hand, patients in financial ‘‘shared-risk’’ programs may choose elective single embryo
transfer (eSET) more often than those patients without insurance and not participating in financial ‘‘risk-sharing’’ programs as they have already committed to potentially undertaking multiple transfer cycles (9). Efforts should be made by providers to promote single blastocyst embryo transfer when appropriate to reduce the risks of multiple gestations. Relatedly, programs may have incentives to add in ancillary tests such as sonohysterography, in cases in which they are not indicated.

When providing traditional fee-for-service or financial ‘‘risk-sharing’’ programs, beneficence should be practiced and standard of care should be followed. Non-‘‘risk-sharing’’ fee-for-service programs also have incentives to overstimulate the ovaries or transfer multiple embryos in order to have high enough success rates to attract future patients or to add expensive ancillary services. The Committee did not find that the incentives are so much greater in ‘‘risk-sharing’’ plans that they deserve condemnation independently of comparable risks in fee-for-service plans. Because of the potential for conflicts of interest, however, programs should be cautioned to follow recommended ASRM practice guidelines when financial ‘‘risk-sharing’’ programs are in place, as they would be expected to do in any event. Additionally, outcomes for patients participating in financial ‘‘risk-sharing’’ programs should periodically be reviewed to ensure that
the ethical concerns addressed in this document are not violated.


CONCLUSION

The Committee finds that the financial ‘‘risk-sharing’’ form of payment for IVF is an option that might be ethically offered to patients without health insurance coverage for IVF if certain conditions that protect patient interests are met. These conditions are that the criterion of success is clearly specified in advance of enrollment, that patients are fully informed of the financial costs and advantages and disadvantages of such programs, that informed consent materials clearly inform patients of their clinic-specific chances of success if found eligible for the financial ‘‘risk-sharing’’ program, that clinics follow standard protocols/guidelines for these patients (i.e., standard stimulation and number of embryos transferred), and that the program is not guaranteeing pregnancy and/or delivery. It also should be clear to patients that they will be paying a higher cost for IVF if they in fact succeed on the first or second cycle than if they had not chosen the financial ‘‘risk-sharing’’ program, and that in any event the costs of screening and drugs are not included. Finally, programs should not engage in medical practices that fall outside of ASRM practice guidelines in the effort to achieve success.


Acknowledgments:

This report was developed by the Ethics Committee of the American Society for Reproductive Medicine as a service to its members and other practicing clinicians. While this document reflects the views of members of that Committee, it is not intended to be the only approved standard of practice or to dictate an exclusive course of treatment in all cases. This report was approved by the Ethics Committee of the American Society for Reproductive Medicine and the Board of Directors of the American Society for Reproductive Medicine.

This document was reviewed by ASRM members and their input was considered in the preparation of the final document. The following members of the ASRM Ethics Committee participated in the development of this document. All Committee members disclosed commercial and financial relationships with manufacturers or distributors of goods or services used to treat patients. Members of the Committee who were found to have conflicts of interest based on the relationships disclosed did not participate in the discussion or development of this document.

Judith Daar, J.D.; Jean Benward, M.S.W.; Lee Collins, J.D.; Joseph Davis, D.O.; Leslie Francis, Ph.D., J.D.; Elena Gates, M.D.; Elizabeth Ginsburg, M.D.; Sigal Klipstein, M.D.; Barbara Koenig, Ph.D.; Andrew La Barbera, Ph.D., H.C.L.D.; Laurence McCullough, Ph.D.; Richard Reindollar, M.D.; Mark Sauer, M.D.; Rebecca Sokol, M.D., M.P.H.; Sean Tipton, M.A.; Lynn Westphal, M.D.

REFERENCES

  1. RESOLVE. Website, Insurance coverage in Your State. Available at: http://www.resolve.org/family-building-options/insurance_coverage/state-coverage.html. Accessed July 21, 2016.
  2. Chambers GM, Adamson GD, Eijkemans MJ. Acceptable cost for the patient and society. Fertil Steril 2013;100:319–27.
  3. Seattle Fertility. Shared risk refund case studies. Vol. 4, 29 October 2006 [30 August 2015]. Available at: https://web.archive.org/web/20061029214140/http://www.seattlefertility.com/downloads/sharedRiskCaseStudies.pdf. Accessed May 17, 2016.
  4. Levens ED, Levy MJ. Ethical application of Shared Risk programs in assisted reproductive technology. Fertil Steril 2011;95:2198–9.
  5. Hawkins J. Financing fertility. Harvard J Legis 2010;47:115–65.
  6. Stassart JP, Bayless RB, Casey CL, Phipps WR. Initial experience with a risksharing in vitro fertilization-embryo transfer program with novel features. Fertil Steril 2011;95:2192–7.
  7. American Medical Association. Council on Ethical and Judicial Affairs. Code of Medical Ethics Opinion 6.01-Contingent Physician Fees (updated June 1994). [15 November 2015]. Available at: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion601.page? Accessed May 17, 2016.
  8. Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. Guidelines on number of embryos transferred. Fertil Steril 2009;92:1518–9.
  9. Stillman RJ, Richter KS, Banks NK, Graham JR. Elective single embryo transfer: a 6-year progressive implementation of 784 single blastocyst transfers and the influence of payment method on patient choice. Fertil Steril 2009;92:1895–906.

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IUI or IVF

Should other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used for an IUI or an IVF cycle View the Answer
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IVF Case Rates

What ICD-10 codes apply to case rates? View the Answer
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IVF Consent Counseling

When a patient is scheduled to undergo IVF and the provider schedules the patient for a 30-minute consultation is this visit billable? View the Answer
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Ovulation Induction Monitoring for IUI

We would like to clarify the correct ICD 10 diagnosis code for monitoring of an IUI cycle.  View the Answer
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In Vitro Maturation

Have CPT codes been established for maturation in vitro? View the Answer
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IVF Billing Forms

I am seeking information on IVF insurance billing guidelines.  View the Answer
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IVF Billing Globally

Am I correct in assuming that it is duplicate billing for both the ambulatory center and embryology laboratory to bill globally? View the Answer
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IVF Billing of Professional Charges

Are we allowed to bill professional charges under the physician for the embryologist who performs the IVF laboratory services? View the Answer
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Lab Case Rates

What ICD-10 codes apply to case rates? View the Answer
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Oocyte Denudation

Is there is a separate code for denudation of oocytes?  View the Answer
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IV Fluids During Egg Retrieval

Is it appropriate to bill the insurance company for CPT 96360, Under Hydration Infusion when being used in conjunction with IVF retrieval? View the Answer
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Endometrial Biopsy/Scratch

What CPT code should be used for a “scratch test”?  View the Answer
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Endometriosis and Infertility

For treatment like IVF would we bill with N97.x first or an endometriosis diagnosis? View the Answer
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Follicle Monitoring For Diminished Ovarian Reserve

If a patient has decreased ovarian reserve (ICD-10 E28.8) and patient is undergoing follicle tracking to undergo either an IUI cycle or IVF cycle... View the Answer
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Global Billing Vs Billing Under Provider

For an IVF cycle (that is not being billed global to an insurance plan) is it appropriate to bill the charges under one “global” provider? View the Answer
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Diagnosis of Infertility for IVF Procedure

How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures?  View the Answer
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Egg Culture and Fertilization

We are billing for the technical component of 89250 and would like to also bill a professional component of the 89250. View the Answer
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Egg Culture and Fertilization: Same Gender

A same-sex male couple requested half their donor eggs be fertilized with sperm from male #1 and the other half fertilized from male #2. View the Answer
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Donor Embryos

Could you give guidance for the correct ICD-10 code(s) to use when a patient is doing an Anonymous Donor Embryo Transfer cycle? View the Answer
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Journal Club Global: Natural versus Programmed FET Cycles

A significant portion of IVF cycles now utilize frozen embryo transfer.
View the Video
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Role of assisted hatching in in vitro fertilization: a guideline (2022)

There is moderate evidence that assisted hatching does not significantly improve live birth rates in fresh assisted reproductive technology cycles View the Committee Opinion
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Journal Club Global - Best Practices of High Performing ART Clinics

This Fertility and Sterility Journal Club Global discusses February’s seminal article, “Common practices among consistently high-performing in vitro fertilization programs in the United States: a 10 year update.” View the Video
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Guidance on the limits to the number of embryos to transfer: a committee opinion (2021)

ASRM's guidelines for the limits on the number of embryos to be transferred during IVF cycles have been further refined ... View the Committee Opinion
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Journal Club Global Live from India - Adjuvants in IVF and IVF Add-Ons for the Endometrium

Many adjuvants have been utilized by IVF centers to improve their success rates. View the Video
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Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021)

A review of success rates, factors that may impact success rates, and  outcomes. View the Committee Opinion
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Development of an emergency plan for in vitro fertilization programs: a committee opinion (2021)

All IVF programs and clinics should have a plan to protect fresh and cryopreserved human specimens (embryos, oocytes, sperm). View the Committee Opinion
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In vitro maturation: a committee opinion (2021)

The results of in vitro maturation (IVM) investigations suggest the potential for wider clinical application.  View the Committee Opinion
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Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)

The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment.  View the Committee Opinion
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Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)

The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
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The role of immunotherapy in in vitro fertilization: a guideline (2018)

Adjuvant immunotherapy treatments in in vitro fertilization (IVF) aim to improve the outcome of assisted reproductive technology (ART) in both the general ART population as well as subgroups such as patients with recurrent miscarriage or implantation failure. View the Committee Opinion
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Performing the embryo transfer: a guideline (2017)

A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial. (Fertil Steril® 2017;107:882–96. ©2017 by American Society for Reproductive Medicine.) View the Committee Guideline
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Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)

ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint Guideline
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In Vitro Maturation Special Interest Group (IVMSIG)

IVMSIG strives to define the best strategies to optimize IVM outcomes. Learn more about IVMSIG

Topic Resources

View more on legal/ethical issues
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Apr 30, 2024, 3:00PM CT - "What is an Embryo’? Historical, psychological, and legal answers and implications

While an embryo is defined as “a fertilized egg that has begun cell division”, the meaning ascribed to embryos is far more complex.

Register Now
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Planned oocyte cryopreservation to preserve future reproductive potential: an Ethics Committee opinion (2023)

Planned oocyte cryopreservation is an ethically permissible procedure that may help individuals avoid future infertility. View the Committee Opinion
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Ethical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)

Telemedicine has the potential to increase access to and decrease the cost of care. View the Committee Opinion
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ASRM Today: Policy Matters: Policy Roundup

On this episode of Policy Matters the ASRM Government Affairs Office brings us up to date on the past year of policy news and advocacy. Listen to the Episode
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Interests, obligations, and rights in gamete and embryo donation: an Ethics Committee opinion (2019)

This Ethics Committee report outlines the interests, obligations, and rights of all parties involved in gamete and embryo donation: both males and females who choose to provide gametes or embryos for use by others, recipients of donated gametes and embryos, individuals born as a result of gamete or embryo donation, and the programs that provide donated gametes and embryos to patients. View the Committee Opinion
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The Supreme Court Overturns Right to Abortion, Raising Questions and Uncertainties for ART Patients and Providers

A summary of the U.S. Supreme Court’s ruling and various opinions in Dobbs v. Jackson Mississippi Women’s Health. View the Column
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Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion (2022)

Providers may conclude that the medical risks of fertility treatment for a given patient are too high, in which case it is ethical for them to decline to provide treatment. View the Committee Opinion
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Access to fertility services by transgender and nonbinary persons: an Ethics Committee opinion (2021)

The provision of fertility services to transgender individuals and the denial of access to fertility services is not justified. View the Committee Opinion
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Interpretation of clinical trial results: a committee opinion (2020)

Evidence from clinical trials is fundamental to ethical medical practice. View the Committee Opinion
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Ethics in embryo research: a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee (2020)

Scientific research using human embryos advances human health and offspring well-being and provides vital insights into the mechanisms for reproduction and disease. Research involving human embryos is ethically acceptable if it is likely to provide significant new knowledge that may benefit human health, well-being of the offspring, or reproduction. View the Committee Opinion
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Compassionate transfer: patient requests for embryo transfer for nonreproductive purposes (2020)

A patient request to transfer embryos into her body in a location or at a time when pregnancy is highly unlikely ... View the Committee Opinion
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Use of preimplantation genetic testing for monogenic defects (PGT-M) for adult-onset conditions: an Ethics Committee opinion (2018)

Preimplantation genetic testing for monogenic diseases for adult-onset conditions is ethically permissible for a range of conditions including when the condition is serious and no safe, effective interventions are available. View the Committee Document
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Child-rearing ability and the provision of fertility services: an Ethics Committee opinion (2017)

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. View the Committee Opinion
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Using family members as gamete donors or gestational carriers (2017)

The use of adult intrafamilial gamete donors and gestational surrogates is generally ethically acceptable when all participants are fully informed. View the Committee Document
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Disclosure of medical errors involving gametes and embryos: an Ethics Committee opinion (2016)

Medical providers have an ethical duty to disclose clinically significant errors involving gametes and embryos as soon as they are discovered. Clinics also should have written policies in place for reducing and disclosing errors. View the Committee Document
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Informed consent and the use of gametes and embryos for research: a committee opinion (2014)

The ethical conduct of human gamete and embryo research depends upon conscientious application of principles of informed consent. View the Committee Opinion

Ethics Opinions

Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.
Ethics Committee teaser

Planned oocyte cryopreservation to preserve future reproductive potential: an Ethics Committee opinion (2023)

Planned oocyte cryopreservation is an ethically permissible procedure that may help individuals avoid future infertility.
Ethics Committee teaser

Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion (2024)

Clinicians should encourage disclosure between intimate partners but should maintain confidentiality where there is no harm to the partner and/or offspring.
Ethics Committee teaser

Ethical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)

Telemedicine has the potential to increase access to and decrease the cost of care.
Ethics Committee teaser

Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)

In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care.

More Resources

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ASRM Academy on the Go

ASRM MAC Tool 2021

The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.

View the MAC Tool
EMR Phrases teaser
Practice Guidance

EMR Shared Phrases/Template Library

This resource includes phrases shared by ASRM physician members to provide a template for individuals to create their own EMR phrases.

View the library
Practice Committee Documents teaser

ASRM Practice Documents

These guidelines have been developed by the ASRM Practice Committee to assist physicians with clinical decisions regarding the care of their patients.

View ASRM Practice Documents
Ethics Committee teaser

ASRM Ethics Opinions

Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.

View ASRM Ethics Opinions
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Practice Guidance

Coding Corner Q & A

The Coding Corner Q & A is a list of previously submitted and answered questions from ASRM members about coding. Answers are available to ASRM Members only.

View the Q & A
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Practice Guidance

COVID-19 Resources

A compendium of ASRM resources concerning the Novel Corona virus (SARS-COV-2) and COVID-19.

View the resources
Couple looking at laptop for online patient education materials

Patient Resources

ReproductiveFacts.org provides a wide range of information related to reproductive health and infertility through patient education fact sheets, infographics, videos, and other resources.

View Website