Attitudes of Israeli gynecologists regarding candidate screening and personal responsibility in assisted reproductive technologies versus adoption in Israel


      Background: Although both assisted reproduction technologies (ART) and adoption services are designed to help childless couples, their legal status is overwhelmingly different. In particular, applicants for adoption services in Israel are required to undergo a meticulous background check, whereas ART has no such precondition. The present study evaluated the attitude of gynecologists in Israel towards this difference and their opinion of their own responsibility to children born by in vitro fertilization (IVF) treatment. Methods: One hundred and eighty-one gynecologists were asked to complete a questionnaire covering their opinions on the acceptance of applicants for IVF programs compared to adopting couples and their professional responsibility to children born by IVF. Results: Average age of the responders was 47.9±9.2 years; 75% were male; average number of own children was 2.6±1.3. Sixty-one percent believed that the use of IVF conferred a duty upon the physician to ensure the well-being of the future child, and 66% believed it important to somehow screen potential parents. Forty percent favored equalizing the preconditions for IVF candidates and adopting couples. Thirty-five percent supported changing the adoption laws to make the process easier, and 33% supported changing the IVF program to prevent unsuitable candidates from starting therapy. Among the latter, a strong marital bond was considered important by 17%, health status of the potential parents by 72%, and possession of a criminal record by 35%. Forty percent favored parental evaluation by a social worker, and 66%, by a psychological assessment. Only 24% thought that economic status was important. Conclusions: Most gynecologists in ART programs believe they have a duty to look out for the unborn child. Approximately one-third support the institution of changes in parental evaluation to facilitate the adoption process and to provide more restrictions in ART programs. Most believed that parental evaluation, preferably by a psychological assessment, is important prior to starting an IVF program.


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