Access to services at assisted reproductive technology clinics: A survey of policies and practices

OBJECTIVE: Our goal was to investigate policy on patient access to services at assisted reproductive technology clinics in the United States. STUDY DESIGN: Surveys asked about a variety of ethically and socially chall enging cases and were mailed to directors of all Society for Assisted Repro ductive Technology-associated assisted reproductive technology clinics. RESULTS: Written policies on access to services are present at 40% of assis ted reproductive technology clinics. Universal agreement was not found on a ny issue; 79% of clinics treat single women, 27% treat patients with a hist ory of schizophrenia, 10% treat patients who use alcohol excessively, 7% tr eat human immunodeficiency virus-positive women, and 2% would treat patient s previously convicted of child abuse. A breakdown of the responses indicat ed that some clinics are more permissive in terms of access to services tha n others, whereas some are more restrictive. CONCLUSIONS: The data demonstrate considerable variability in policy among clinics on most access-to-services questions. The results highlight the imp ortance of ongoing discussion of the ethical and legal issues related to ac cess and the need to develop consistent methods to deal with complex cases.