MEDICINE : Pressure Growing to Regulate Infertility Clinics, Surrogates

Legislators are under increasing pressure to develop laws regulating the growing industry of infertility treatment, infertility experts say.

Last year, bills were introduced in Congress to accredit and monitor infertility treatment centers and regulate surrogacy arrangements.

Other proposed legislation sought to guarantee insurance coverage of infertility treatment for federal and military employees and mandated more research on infertility.

None of the bills was enacted last year, but debate on infertility treatment issues is expected to be renewed during the next congressional session.

“I think this issue is going to be as hot in 1991,” said Andrea Camp, an aide to Rep. Patricia Schroeder (D-Colo.). “We’ve had a lot of contact from senators on it.”

Schroeder backed a bill authorizing insurance coverage of infertility treatment for federal and military employees that she hoped would serve as a catalyst for widespread insurance coverage of infertility treatment, Camp said. The bill died but will be reintroduced this year.

Another bill that is expected to be reintroduced this year would force clinics to show proof of their ability to perform sophisticated infertility treatments and to publish their success rates. The bill, introduced last year by Rep. Ron Wyden (D-Ore.), would set minimum standards for quality assurance, record-keeping and the qualifications of lab personnel.

ISSUES: Much criticism of the field has focused on the claims of many physicians who open such treatment facilities. Success rates for such procedures as in vitro fertilization, surrogacy and egg donation vary widely among clinics, and consumers have no way to verify the abilities of the specialist treating them or a clinic’s success rate.

Many veteran infertility specialists support the bill, said Dr. Geoffrey Sher, medical director of the Pacific Fertility Centers in San Francisco and Torrance.

“We need to get our own house in order,” said Sher, the author of the book, “From Infertility to In Vitro Fertilization.” “We need an accreditation process that deals with all aspects of quality assurance. We have 290 (in vitro fertilization) programs in the United States, yet three-quarters of all babies come out of 20 or 30 programs. People need to know information that can help them decide where to go based on the results of programs.”

Legislators, however, have not been eager to address the dilemmas resulting from assisted reproductive technologies, said attorney William W. Handel, co-director of the Center for Surrogate Parenting in Beverly Hills.

“It’s a no-win situation for most legislators,” he said. “It’s enormously complex and sophisticated. The ramifications are profound and there are no easy answers.”

IMPACT: According to Sher, accreditation of clinics would be an important first step to bringing the technology into social acceptance and clarify many of the legal and ethical problems that have led to lawsuits in the past decade.

These legal and ethical dilemmas include arguments over the parentage of a child born to a surrogate mother, the disposition of frozen embryos when a couple divorces and the payment of egg and sperm donors. Some states have formulated laws governing these issues.

Other experts are unconvinced that an accreditation process will help clarify the continuing controversies.

“I don’t think Rep. Wyden’s act is going to do anything to straighten out some of the social and legal issues,” said Dr. Arthur Wisot, an infertility expert at South Bay Hospital in Redondo Beach and co-author of a book on infertility.

But Wisot said he would like to see legislation governing surrogacy and related issues rather than see continuing court battles.

“The courts are not there to make laws,” he said. “They are there to interpret the laws. I think the Legislature should mandate what is right and what is not right.”