Patients are entitled to maximal IVF pregnancy rates.
IVF programmes generally follow treatment protocols that strive for best outcomes. Deviations from such established protocols, even if conceptionally well supported, always risk potentially adverse effects on pregnancy chances. Successful pregnancy represents, however, the principal motivation for all fertility treatments. As a universal medical principle, patients are, therefore, entitled to maximal professional efforts towards their desired outcomes in the safest, quickest and most cost-effective ways. For IVF this means, as multiple patient queries in the literature have demonstrated, the following parameters in this order of importance: highest possible pregnancy rates, lowest possible risks, shortest possible time and lowest possible cost. Some recently widely propagated changes to broadly utilized practice patterns in IVF now, post factum, have been determined to be clinically useless and, in addition, have been shown to adversely affect pregnancy chances. Also post factum, this has led to the acknowledgement that significant modifications to established IVF practice should be introduced with caution. In view of the quite satisfactory IVF pregnancy rates that are currently achieved, the uncontrolled introduction of significant protocol modifications, which may adversely affect IVF outcomes, should no longer be acceptable practice as such unproven practice modifications may violate the patient's entitlement to maximally achievable pregnancy rates.
Gleicher
Norbert
N
Oktay
Kutluk
K
Barad
David H
DH
D005260:Female; D005307:Fertilization in Vitro / Q000941:ethics / Q000379:methods / Q000592:standards*; D006801:Humans; D028701:Patient Rights / Q000941:ethics / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors