Assisted reproductive technologies in India: the views of practitioners.

BACKGROUND: This article documents the context of Assisted Reproductive Technology/ies (ART) services and providers' perceptions regarding services offered in India. The objective is to facilitate understanding of critical issues and relevant concerns. METHODS: A postal survey conducted with a sample of 470 gynaecologists and in-depth interviews with 39 gynaecologists in four cities. RESULTS: ART clinics have proliferated in cities and towns; they are commercialised and the quality of treatment is variable. Most providers perceived that patients lack knowledge about infertility and ART, costs are high, investigations unnecessarily repeated and success rates low. ART providers do not have clear selection criteria, some lack rigorous specialised training and infrastructure and most are deficient in record-keeping and counselling and lack transparency. Monitoring and regulation by appropriate authorities are also lacking. CONCLUSION: Both providers and regulatory authorities need to look critically at exploitation of patients and commercialisation, excessive costs, lack of information, informed consent, and transparency, counselling, unethical practices, variations in quality of treatment and ensuring proper monitoring and regulation.