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The regulation of assisted reproductive technologies is a contested area. Some jurisdictions, such as the UK and a number of Australian states, have comprehensive regulation of most aspects of assisted reproductive technologies; others, such as the USA, have taken a more piecemeal approach and rely on professional guidelines and the general regulation of medical practice to govern this area. It will be argued that such a laissez-faire approach is inadequate for regulating the complex area of assisted reproductive technologies. Two key examples, reducing multiple births and registers of donors and offspring, will be considered to illustrate the effects of the regulatory structure of assisted reproductive technologies in the USA on practice. It will be concluded that the regulatory structure in the USA fails to provide an adequate mechanism for ensuring the ethical and safe conduct of ART services, and that more comprehensive regulation is required., (Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: It is widely accepted that infertility and involuntary childlessness, and the decision to engage with assisted reproduction technology (ART) services as a patient, donor or surrogate can entail wide-ranging psychosocial issues. Psychosocial counselling has, therefore, become valued as an integral element of ART services. The objective of this study was to begin to map out what exists globally by the way of guidelines for infertility counselling., Methods: Data were analysed from formal guidelines produced by seven national infertility counselling bodies, onetransnational infertility counselling organization, reports of the American Society for Reproductive Medicine Ethics Committee and Practice Committee and the ESHRE Task Force on Ethics and Law. Additional sources of data were the International Infertility Counseling Organization and counselling colleagues internationally., Results: Four broad areas concerning contemporary practice in infertility counselling are identified: (i) the legal mandate for counselling; (ii) eligibility credentials for individuals carrying out professional counselling activities; (iii) different forms of counselling and (iv) counselling practice in relation to specific elements of assisted reproduction treatment., Conclusions: Internationally, the development of infertility guidelines is best described as a 'work in progress', although key trends are evident.

Background: Currently, there is little evidence about conditional relinquishment of frozen embryos to others for family-building. This paper begins to address this gap by reporting findings from a study that investigated the experiences of couples who chose to relinquish their embryos conditionally through an embryo 'adoption' programme., Methods: An exploratory qualitative study was conducted between September 2008 and December 2009. Participants were recruited from a Christian embryo 'adoption' programme in the USA. Forty-three people (18 couples and 7 wives) participated in in-depth email interviews., Results: The data show that the following factors contributed to the participants choosing an embryo 'adoption' programme: how they conceptualized their embryos; dislike of alternative disposition options available; conceptions of their parental responsibility towards their embryo and a desire to have an 'open' relinquishment with (varying) degrees of information-sharing and contact arrangements between themselves and recipient couples., Conclusions: This study identifies a diversity of views on embryo relinquishment and some couples' wishes for elements of conditional relinquishment that are offered by embryo 'adoption' programmes. A range of disposition options should be available to enhance choice for those with unused embryos so that they can relinquish in ways that are both morally and practically acceptable to them. The current polarized debate concerning the language of embryo 'adoption' detracts attention from the practical considerations of formulating 'best practice' in this area. These considerations are better addressed by the use of less politically charged terminology such as 'conditional relinquishment'.