Lars Noah, Assisted Reproductive Technologies and the Pitfalls of Unregulated Biomedical Innovation.

55 FLA. L. REV. 603 (2003).

Assisted reproductive technologies (ARTs) come in many forms and have gained fairly rapid acceptance in spite of the fact that most infertility patients must pay the costs out of pocket and that many of these treatments have arrived on the scene with little or no rigorous testing of their safety and effectiveness. Researchers have long recognized that some fertility treatments increased the odds of a multifetal pregnancy, which poses significant risks to maternal and fetal health, and newer studies have identified other safety concerns such as birth defects associated with particular ARTs. Notwithstanding a growing appreciation of such risks, however, doctors and patients seem unable or unwilling to take steps necessary to curb the overuse of ARTs or to reduce the likelihood of multiple births.

ART now encompasses three distinct methods, though they are often used in combination. Artificial insemination, also referred to as intrauterine insemination, which instrumentally introduces the sperm collected from a donor into a woman's uterus, has the longest history and requires the least technological sophistication; gamete intrafallopian transfer, which delivers the donor sperm and harvested eggs directly into the woman's fallopian tube, represents a more complicated method of insemination; and in vitro fertilization, which transfers one or more embryos into the fallopian tubes or uterus, after fertilizing a harvested egg with donor sperm in a petri dish. Injection of drugs that induce ovulation by first stimulating the follicles and then releasing the mature ova precedes all forms of ART.

Unlike other medical technologies, ARTs arrive on the scene with little or no rigorous testing of their safety and effectiveness. A number of researchers have documented that fertility drugs and IVF increase the incidence of multiple births. Such pregnancies pose a variety of significant health risks to both mothers and children. For instance, prematurity and low birth weight can result in long-term developmental harms in offspring. Before recent advances in neonatotogy, "preemies" often failed to survive. Nowadays, after lengthy stays in neonatal intensive care units, many premature infants leave the hospital only to face significant physical and cognitive disabilities.

Multifetal pregnancies pose numerous maternal risks as well, including gestational diabetes and preeclampsia. In addition, ART procedures raise a variety of other...