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Evidence Library · Choice and consent

What the fertility field says its own consent standard is

There is a published ethics opinion. Most patients have never seen it.

The fertility field has its own published ethics opinion on informed consent in assisted reproduction. It exists, it is short, and it is worth knowing that it exists when you are handed a stack of forms at a first appointment.

The consent standard set out in this guide's opening applies here in a form that is arguably harder to meet than in obstetrics, for three reasons:

You are paying. In most of US fertility care the person recommending the treatment is also selling it. That is not an accusation of bad faith. It is a structural feature that consent has to work around, and naming it is part of working around it.

The alternatives include doing nothing, and doing nothing has published numbers. Expectant management is a real option with real success rates, covered in the next stage. If nobody has quoted you those numbers, you have not been told all your options.

You may be the one asking for the unproven thing. Bioethicists have looked at this directly and argued that in a commercial setting, "the patient asked for it" is not on its own an adequate professional justification for providing a treatment that does not work. That argument, and what it means for you, is taken up in the last topic of this part.

The one question to open with"What would happen if we did nothing for six more months? Do you have a number for that?"

It is not an adversarial question. It asks for the one piece of information that every other decision in this part depends on, and it is the piece most often left out. The full list of questions worth writing down is in the closing topic, Being heard in fertility care.
Where this comes from:
123. Ethics Committee of the American Society for Reproductive Medicine. Informed consent in assisted reproduction: an Ethics Committee opinion. Fertil Steril. 2023;119(6):948-953.
124. Stanbury C, Lipworth W, Gallagher S, Norman RJ, Newson AJ. What moral weight should patient-led demand have in clinical decisions about assisted reproductive technologies? Bioethics. 2024;38(1):69-77.

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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.