Conclusion
This brief review of the efficacy, safety, and costs of IVF demonstrates that this procedure has become accepted medical practice without adequate scientific assessment. Its rapid proliferation especially in the market-oriented USA system, has preceded the type of outcomes research that is essential in order to protect both individual patients and the health care system. In addition, concern over the psychological costs borne by the vast majority of women who unsuccessfully pursue pregnancy through these techniques should warrant a level of caution which to date has not been forthcoming. The demand for pregnancy, the organisation of medical specialties surrounding these procedures, the open-ended reimbursement and incentive structure, and powerful market forces make it unlikely that IVF and a whole range of medical technologies can be regulated without some semblance of a national health system. These findings clearly reinforce the themes raised by the Radical Statistics Health Group and illustrate some of the weaknesses of a market approach to medical care.
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References
Butter, I. H. (1993) Premature adoption and routinisation of medical technology: illustrations from childbirth technology.Journal of Social Issues 49(2), 11–34.
Cundiff, D. and McCarthy, M. E. (1994).The Right Medicine: How to Make Health Care Reform Work Today, Humana Press, Totowa NJ.
Rublee, D. A. (1994). Medical technology in Canada, Germany and the United States.Health Affairs 13(4), 113–117.
Aaron, H. J. (1991)Serious and Unstable Condition: Financing America's Health Care, The Brookings Institution, Washington DC.
Bonnicksen, A. L. (1989).In Vitro Fertilisation: Building Policies from Laboratories to Legislation. Columbia University Press, New York.
Baird, P. (1993).Proceed with Care: Final Report of the Royal Commission on New Reproductive Technologies. Minister of Government Services Canada, Ottawa.
Caplan, A. L. (1990). Arguing with success:in vitro fertilisation research or therapy?' In,Beyond Baby M.: Ethical Issues in New Reproductive Techniques, ed. by D. M. Bartelset al., Humana Press, Totowa NJ.
Haan, G. (1991). Effects and costs ofin vitro fertilisation.International Journal of Technology Assessment in Health Care 7(4), 585–593.
Wagner, M. G. and St. Clair, P. A. (1989). Arein vitro fertilisation and embryo transfer of benefit to all?Lancet (28 October), 1027–1030.
Neumann, P. J., Gharib, S. D. and Weinstein, M.C. (1994). The cost of a successful delivery within vitro fertilisation.New England Journal of Medicine 331(4), 239–243.
Office of Technology Assessment (1988).Infertility: Medical and Social Choices, Government Printing Office, Washington DC.
Schenker, J. G. and Ezra, Y. (1994). Complications of assisted reproduction techniques.Fertility and Sterility 61(3), 411–422.
Callahan, T. L., Hall, J. E., Ettner, S. L.et al. (1994). The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence.New England Journal of Medicine 331(4), 244–249.
Collins, M. and Bleyl, J. A. (1990). Seventy-one quadruplet pregnancies: management and outcome.American Journal of Obstetrics and Gynecology 162. 1384–1392.
Weissman, A., Yoffee, N.et al. (1991). Management of triplet pregnancies in the late 1980s—are we doing better?'American Journal of Perinatology 8, 333–337.
Luke, B. (1994). The changing patterns of multiple births in the United States: maternal and infant characteristics, 1973 and 1990.Obstetrics and Gynecology 84(1), 101–116.
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Blank, R.H. The medical marketplace and the diffusion of technologies. Health Care Anal 4, 321–324 (1996). https://doi.org/10.1007/BF02249320
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DOI: https://doi.org/10.1007/BF02249320