Assisted reproduction clinics under fire for putting business over ethics

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Assisted reproduction clinics in the Czech Republic have an excellent reputation and a long line of clients from at home and abroad. Now they have come under fire from male fertility specialists who claim that what was meant to be a last resort has become a lucrative business.

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Infections, hormonal imbalance or cirsocele –those are the main reasons for male infertility, and according to specialists in 75 to 80 percent of cases they can be easily treated to enable a natural pregnancy.

However the specialists who treat male infertility claim that the country’s assisted reproduction clinics rarely focus on why men have a fertility problem and what can be done to clear it up. Instead they offer couples IVF – assisted reproduction, which is generally successful, but will not help the couple conceive if they want a second child.

Jana from Moravia told Czech Radio that when she and her husband sought help, doctors had advised IVF right away.

“They told us that my husband’s “slow sperm” problem was due to cirsocele (a varicose dilatation of the spermatic vein) which could be cleared up with the help of minor surgery. But they said they were not sure about the result and advised assisted reproduction. They did not ever offer surgery as a first option. And I really think that it was for financial reasons.”

Jana underwent IVF and got pregnant. Although doctors at the clinic gave her husband scant hope that surgery could clear up the fertility problem, he decided to undergo it. It was successful and the couple’s second and third child were conceived naturally.

Male fertility expert Libor Zámečník says this is a common approach at fertility clinics since leaving IVF as a last resort would harm them financially.

“Men can have a simple fertility problem that is fairly easy to treat and that would not necessitate the couple undergoing IVF at all. In the cases of infertility that we are consulted about, I would dare say that we find a solution in 75 to 80 percent of the cases.”

Photo: Filip Jandourek / Czech Radio
Were this to be the case assisted reproduction clinics would lose out, but the health insurance system would gain, since IVF is much more expensive. Deputy Health Minister Roman Prymula says a special commission at the ministry is now looking into the matter in view of setting down certain rules of procedure which would make doctors try all the other options before going for IVF as a last resort.

Insurance companies annually finance IVF treatment to the tune of half a billion crowns and according to Prymula some fertility centres do not even have an agreement with insurance companies for treating male infertility problems. Prymula says he has no idea how much money could be saved by first addressing male infertility, but notes that he is in favour of establishing stricter rules which would make IVFs a form of medical assistance rather than a lucrative business.