title: A survey of the effectiveness of the assessment of the welfare of the child in UK in-vitro fertilization units.
abstract: Seventy-one clinics in the UK offering in-vitro fertilization (IVF) treatment were surveyed for their protocols on the assessment of the welfare of the children produced. A total of 44 (62%) responded. Of these, five (12%) did not have operational protocols, seven (16%) declined to provide their protocols, and 32 (73%) provided information used in the survey. The information was in the form of a protocol for only 16 (50%) of these clinics. The remaining clinics submitted as their 'protocols' letters to general practitioners, patient information, patient questionnaires and/or a copy of their policy on the assessment of child welfare. From the submitted material, it was possible to determine that 94% of clinics seek information on aspects of child welfare assessment, 78% have a procedure for making further enquiries where there is any cause for concern, 44 % include counselling opportunities explicitly in protocols, 30-38% of clinics see a full medical and social history from each prospective parent as part of the child welfare assessment, 16% include explicit consideration of the impact of multiple births on the welfare of the child, and 3% include consideration of the issue of disclosure of the mode of conception of the child on its welfare. Most clinics did not have clearly defined procedures on how to reach a decision on whether or not to treat. Eight clinics (25%) made explicit in their protocols any exclusion criteria. It is concluded that clinics are not currently producing completely effective protocols. Two possible reasons for this are considered: lack of technical knowledge about what constitutes an effective protocol, and lack of clear policy development and propagation underlying protocols within clinics. Possible approaches to improving the situation are considered.
authors.affiliation: Department of Anatomy, Cambridge, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Patel
authors.forename: M H
authors.initials: MH
authors.lastname: Johnson
mesh_terms: D000328:Adult; D002669:Child Welfare / Q000331:legislation & jurisprudence*; D003376:Counseling; D005307:Fertilization in Vitro / Q000331:legislation & jurisprudence*; D006268:Health Facilities; D006801:Humans; D007223:Infant; D010290:Parents; D006113:United Kingdom