Issues surrounding infertility and reproductive medicine are rarely out of the news - delaying motherhood, egg and sperm donation, embryo testing and access to fertility treatment, to name just a few. But the published opinions triggered by this extensive media coverage have tended to be those of a select few doctors, scientists, patient representatives and pressure groups. To date, there has been no concerted effort to find out what most people think about these often controversial topics - even public consultations tend to trigger responses from stakeholders and those with a particular interest in the subject.
In an attempt to address this gap, and to coincide with the launch of a new BBC season on the treatment of infertility ('A Child Against All Odds', see 'Recommends'), the UK charity Progress Educational Trust (PET) recently commissioned a survey to measure public opinion on a wide range of these issues. Over 4,000 people responded to the 70-question survey, which was conducted by YouGov, and the results were released last week. They reveal many interesting, and sometimes surprising, findings.
On the subject of older mothers, two thirds of respondents agree that modern lifestyles are forcing people to delay starting a family for too long (an attitude held equally by men and women, as well as people across all age groups). However, almost seven out of ten people felt that women should accept that choosing a career over children may mean they cannot conceive naturally - almost 80 per cent are opposed to the use of IVF by people aged over 50 years old. When asked what they thought the age limits should be for women, half the respondents said this should be between 40 and 44 and a quarter think it should be between 45 and 49 years. Limits for men are slightly higher - perhaps reflecting the media's generally more sympathetic portrayal of older dads - with one third supporting a limit of 40-44 and a further 29 per cent between 45-49 years.
Public opinion has been cited as the rationale for some policy-making in this area, for example the current ban on sex selection for non-medical reasons in the UK. A consultation carried out by the Human Fertilisation and Embryology Authority (HFEA) in 2003 showed that 80 per cent of the 600 respondents felt it should not be permitted. The new PET survey showed a slightly lower figure, although the vast majority (74 per cent) still disapprove of the use of reproductive technology for this reason, while only eight per cent approve. This begs the question: how much should public opinion influence regulation?
In the case of removing anonymity for people who want to donate eggs, sperm and embryos, the views of the public were not widely sought before the recent change to the law. It followed a consultation which received 237 responses, and a 2003 survey of clinics that revealed most were opposed to the removal of anonymity. But the PET survey shows that 58 per cent of respondents believe egg and sperm donors should have the right to be anonymous, compared to just 28 per cent who agree with the law. Clearly there are some areas of policy in which public opinion is accorded a great deal of importance, and others where it is felt the views of people directly affected (in this case donor-conceived individuals) matter more. Balancing these competing interests is likely to continue to present a challenge to UK lawmakers during the ongoing review of legislation governing fertility treatment and embryology.
All opinion polls have their limitations, as does any form of public consultation. But this latest survey is to be welcomed, as it sheds some light on the views of people who have no particular axe to grind.