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英国人类受精与胚胎学管理局。其对辅助生殖技术评估的贡献。

The U.K. Human Fertilisation and Embryology Authority. How it has contributed to the evaluation of assisted reproduction technology.

作者信息

Doyle P

机构信息

London School of Hygiene and Tropical Medicine.

出版信息

Int J Technol Assess Health Care. 1999 Winter;15(1):3-10. doi: 10.1017/s0266462399015123.

Abstract

The Human Fertilisation and Embryology Act of the United Kingdom was passed in 1990, leading to the formation of the Human Fertilisation and Embryology Authority (HFEA), the first statutory body to regulate and control assisted conception anywhere in the world. The principal function of the HFEA is to license and monitor clinics that carry out in vitro fertilization (IVF), donor insemination (DI), and embryo research. Information on over 135,000 treatment cycles, 20,000 pregnancies, and 25,000 babies following IVF has now been collected as part of the regulatory process, and these data have permitted unbiased and accurate evaluation of treatment efficacy using pregnancy and live-birth rates. The treating clinics are required by law to provide information on the outcome of all births, including neonatal mortality and congenital malformations, but there is no systematic validation of these data using medical records or any follow-up of treated women, or babies, over time. In addition, the strict confidentiality of data supplied to the HFEA means that outside researchers have been unable to access the database for research projects. Thus, at the present time, it is not possible to evaluate the long-term safety of assisted conception procedures using HFEA data. There is reasonable scientific evidence to justify full investigation of the health of both treated women and resulting children. Particular health outcomes requiring evaluation include obstetric complications, preterm births, cerebral palsy, and cancer. The HFEA has recognized the need for follow-up studies and is currently investigating ways of enabling research projects using HFEA data to be undertaken.

摘要

英国的《人类受精与胚胎学法》于1990年通过,促成了人类受精与胚胎学管理局(HFEA)的成立,这是世界上首个对辅助受孕进行监管的法定机构。HFEA的主要职能是对开展体外受精(IVF)、供体授精(DI)及胚胎研究的诊所进行许可和监督。作为监管程序的一部分,现已收集了超过13.5万个IVF治疗周期、2万次妊娠及2.5万名婴儿出生的相关信息,这些数据使得能够利用妊娠率和活产率对治疗效果进行公正且准确的评估。法律要求治疗诊所提供所有出生情况的信息,包括新生儿死亡率和先天性畸形,但并未使用病历对这些数据进行系统验证,也未对接受治疗的女性或婴儿进行长期随访。此外,提供给HFEA的数据严格保密,这意味着外部研究人员无法访问该数据库用于研究项目。因此,目前无法利用HFEA的数据评估辅助受孕程序的长期安全性。有合理的科学证据表明有必要对接受治疗的女性及其所育子女的健康进行全面调查。需要评估的特定健康结果包括产科并发症、早产、脑瘫和癌症。HFEA已认识到进行随访研究的必要性,目前正在研究如何开展利用HFEA数据的研究项目。

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