The UK's Human Fertilisation and Embryology Authority (HFEA) has issued new guidance for IVF clinics on how to consider the welfare of children born following the use of assisted conception techniques. It states that before offering infertility treatment, doctors should take into account the risk of any serious medical, physical or psychological harm to the future child. It has dropped the current requirement for routine checks to be carried out by a patient's family doctor, and the need to consider 'broader social factors'.

Section 13 of the 1990 Human Fertilisation and Embryology Act states that a woman should not be offered fertility treatments 'unless account has been taken of the welfare of any child who may be born as a result of treatment (including the need of that child for a father)'. The new guidance, partly based on responses to a public consultation entitled 'Tomorrow's Children', aims to clarify how this requirement should be interpreted.

The consultation formed part of the first major review of the guidance on Welfare of the Child assessments, as set out in the HFEA's first Code of Practice in 1991. One of the main changes to the existing guidance is that clinics should now only make further enquiries about their patients in cases where they think the child may be at risk of serious harm. Currently, fertility doctors are required to ask every patient's GP to run medical and social checks on prospective parents, a system which can delay treatment. According to Angela McNab, chief executive of the HFEA, 'contacting the GP in every case is ineffective'.

The HFEA has also scrapped the need for clinics to consider social factors such as the patients' ages, their commitment to having children and the stability of their relationship. HFEA chair Suzi Leather said: 'By focusing more clearly on the risk factors that could lead to serious harm, we will have a system that is fairer for parents and more proportionate for doctors while still protecting children's interests'. Clinics will now be asked to assess areas of risk such as any mental and physical conditions that affect the parents, drug and alcohol abuse, previous convictions relating to harming children, the risk of a child being born with a serious medical condition and 'any other aspects of the patient's circumstances which centres consider to be appropriate'.

The HFEA also recommends that patients using donated eggs, sperm or embryos should be encouraged to be open with their children from an early age about the circumstances of their conception. No mention is made of taking into account the child's 'need for a father', currently part of the law, despite the fact that in January 2004, Ms Leather publicly stated that this requirement was 'nonsense'. While some clinics will treat single women and lesbians, others have used this provision to deny them treatment.

Clare Brown, Chief Executive of the charity Infertility Network UK, welcomed the new guidance, saying that until now many infertility patients 'have felt that the assessment was intrusive and overly cautious'. Alison Murdoch, chair of the British Fertility Society, said: 'The 'Welfare of the Child' clause in the HFEA Act has always been a problem. The BFS is pleased that the HFEA is responding to concerns from both clinics and parents'.

The Department of Health (DH) is also seeking views on the Welfare of the Child, as part of its current review of the HFE Act. The public are invited to respond formally to the DH. BioNews readers and any other interested individuals are also invited to informally debate their views on the welfare of the child, on a DH-funded online discussion forum run by Progress Educational Trust - the charity that publishes BioNews. Issues such as the need for a father, telling donor-conceived children about their origins and patient's views are currently being discussed in the 'Welfare of the Child' area. Feedback from this time-limited website will be submitted to the DH after the public consultation closes on 25 November 2005. Your views are much valued and all are welcome to contribute.

Reproduced from BioNews with permission, a web- and email-based source of news, information and comment on assisted reproduction and human genetics, published by Progress Educational Trust.