Ethical considerations in the management of infertility

Ethical issues arising in the day-to-day practice of infertility treatment are important and sometimes difficult. A couple's infertility problem usually has affective and social dimensions, sometimes disrupting their lives. Responsible care involves dealing with these psychosocial factors, including counseling and striving for informed patient decision making. The ethical problem of whether to provide treatment when the probability of success is low is sometimes complicated by a couple's desperate desire for fertility. In such cases the physician weighs various factors, including the risks of the procedure, the harm that might result from continuing infertility and the degree of the couple's understanding of the pros and cons. Issues of truth telling are raised by a lack of third-party reimbursement for infertility workup and treatment. Also, questions about when to refer or terminate the workup and therapy involve ethical reflection about potential conflicts of interest.