SCREENING IN OR OUT OF THE NEW REPRODUCTIVE OPTIONS - WHO DECIDES ANDWHY

A lively controversy exists among infertility specialists about the va lue and necessity of screening candidates for inclusion into infertili ty programs. Advocates of screening argue that there is both a child a dvocacy and community welfare responsibility Co evaluate prospective c andidates (and donors) for the new assisted reproductive techniques. O pponents of screening argue that screening is costly and superfluous, since the majority of applicants are highly motivated and well-adjuste d individuals who have the 'right' to pursue parenthood, if they choos e. A pilot survey was undertaken to determine whether infertility prog rams currently have explicit policies regarding suspension or refusal of treatment on psychological grounds and to determine what would (or should) constitute grounds for denial of infertility treatment. A Trea tment Refusal Questionnaire was mailed to all members of the Psycholog ical Special Interest Group of the American Fertility Society. Forty-t wo responded (response rate of 47%) Results revealed that the majority of respondents did not have a formal policy regarding suspension or r efusal of treatment, although they did have informal criteria. Four cr iteria were significantly endorsed as constituting 'red flags' for tre atment rejection: substance abuse, physical abuse, severe marital stri fe, and coercion of one spouse by another. Furthermore, treatment deci sions were modified by the type of intervention sought, so that for ex ample, more stringent criteria were operative if clients sought ovum d onation than if they sought ovulation induction. These and other findi ngs are presented and discussed.