According to a report on assisted reproduction by the International Federation of Fertility Societies, Taiwan is the only nation out of 107 countries that allows its doctors, in the absence of clinical guidelines to substantiate the existing laws and regulations, to implant five embryos. Therefore, a consistent 40 percent of artificial insemination procedures in Taiwan result in multiple births, something the TSRM deems unacceptable.
It is only natural for childless couples paying for artificial insemination to embrace multiple embryo placements if this will increase their chances of a successful pregnancy, Lee said. If the government is footing the bill, the Bureau for Health Promotion can demand that the number of implants be restricted, but if the couple is paying for the treatment on the private market, it is unlikely that the number of embryos can be limited to two, he added.
Chen Hsin-fu (陳信孚), a doctor at National Taiwan University, believes that multiple embryo placement is misguided.
There are too many concomitant risks: The heightened risk of having to conduct selective reduction abortions, the dangers of multiple pregnancies and the long-term burden on the national health insurance due to problems such as the provision of care for prematurely born children or those with conditions such as cerebral palsy, undeveloped lungs or eye problems.
The issue is not whether national health insurance should cover artificial insemination. Money is already being spent on the entirely avoidable side-effects of the current government policy on embryo placement restrictions.
Reform is never easy and the new guidelines have come not a minute too soon, but it is always prudent to err on the side of caution.
Chiang Sheng is an attending physician in the Department of Obstetrics and Gynecology at Mackay Memorial Hospital.
Translated by Paul Cooper