Innovation, Commerce and Assisted Reproductive Technology: Opportunities and Challenges

Abstract

Background: The increasing demand for ART services in Australia has supported the development of a significant number of private sector commercial providers. This sector is innovative and research active, but the effects of commercial influences on research and clinical innovation have not been fully explored. Here we report on the results of a National Health and Medical Research-funded project exploring the views and experiences of professionals working in the ART field. Aims: To elucidate the views and experiences of expert stakeholders regarding research and innovation in the ART sector. Method: We interviewed 31 ART industry stakeholders including medical, nursing, counselling, management and scientific staff, owners/directors, regulators, advocates, and referring clinicians using a standardised semi-structured interview guide. Participants were asked about strengths and weaknesses of the current system and what, if any, reform is necessary. Three team members coded the data for themes relevant to research and innovation and analysed it in accordance with the principles of thematic analysis. Results: There are several positive impacts of commercial forces on research and innovation, including competition, scale, and clinicians’ financial stake in research. Commercialised services can more easily commit to large national, transnational and technology-intensive research projects, and they can translate results rapidly into practice. It is, however, difficult to perform clinical trials in the ART setting and there are incentives to implement interventions in advance of comprehensive evaluation. Clinical innovation is a crucial component of ART practice, but it is hampered by lack of a clear, agreed distinction between innovation, experimentation, and ‘add-on’ treatments; deficiencies in the formal processes used to appraise the outcomes of innovation and challenges of communication and consent. Conclusions: Professionals who have a deep understanding of research and innovation in the ART sector recognise both benefits and harms of its current commercial organisation. To harness the benefits of commercialisation, the ART industry requires a fair, sustainable, coordinated and needs based approach to research funding and a consistent and principled-based approach to clinical innovation.