A comparison of assisted human reproduction (AHR) regulation in Ireland with other developed countries

Abstract

Background Assisted human reproduction (AHR) treatment is not regulated in Ireland although it has been practiced since 1987. Thus, Ireland is one of the only European countries without any form of AHR specific regulation. This literature review research aimed to provide a comprehensive and comparative overview of AHR regulation and any associated literature to compare Ireland and other developed countries. Methods Systematic searches were conducted in several databases (Google Scholar, Web of Science, MEDLINE, SCOPUS and official government websites) utilising search strings in relation to AHR legislation for each country under review. A final review of 155 research articles were eligible after screening related to legislation in each country for inclusion. The findings were synthesised and summarised by legislation in each country. Results Different countries offer different levels of ART and IVF provision and services in terms of the type of services allowed, financial support, age, sex and eligibility of recipients. The UK’s oversight legislation combined with the Netherlands financial legislation section provides as being most effective hybrid model of best practice for adoption in Ireland. Conclusions This research concluded that there is no AHR legislation in any country that can be described as all-encompassing in terms of the services allowed, financial support and age of recipients. It was concluded that significant changes need to be made to the Irish draft legislation which is in limbo with the government for the last 3 years in order to meet Irish patient needs.

The Lack of Ireland’s Assisted Human Reproduction (AHR) Regulation Viewed under the Lens of the Patient’s Experience

“…Many Irish couples travel to European countries to access AHR services in more regulated and cost-effective jurisdictions. A previous study by some of this papers authors McDermott, Ronan and Butler, in early 2022, supported recommendations from many other studies and the Irish public that revisions be made to the draft legislation in order to meet Irish patient needs [ 15 ]. The study also concluded that as a benchmark and best practice model, a hybrid system similar to the UK’s and the Netherland’s AHR regulatory system would be ideal.…”

“…Legislated AHR treatment is the best practice around the world and can ensure a uniform and controlled service provision. International best practice also promotes that AHR treatments be at least partially funded by governments [ 11 , 15 , 30 ].…”

“…The new proposed Irish legislation will introduce a dedicated, competent authority—the assisted human reproduction regulatory authority (AHHRA), which will provide regulatory oversight of Irish AHR. The objective of the AHHRA is to protect, promote and, as far as is practicable, ensure the health and wellbeing of children born as a result of assisted human reproduction, the intending parents, and other persons involved in the process [ 15 ].…”

“…This study aims to follow up on the aforementioned legislative study by McDermott et al in 2022 [ 15 ] and investigate the effects and experiences of Irish patients undergoing AHR. The authors will review how the absence of legislation (at the time of the research) may be affecting treatment and patient experiences.…”

The Pandora’s box of transparency opened by direct-to-consumer genetic testing

“…The regulation in some countries has moved (McDermott et al, 2022) from the protection of anonymity to its total prohibition or to the donor-conceived individual's right to know their origin at a certain age.…”