{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:20:17Z","timestamp":1792038017224,"version":"4.4.0"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":74,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hastings Center Report"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add\u2010on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever\u2010increasing array of add\u2010ons are marketed to ART patients, even when evidence to support them is equivocal. A defining feature of ART is hope\u2014hope that a cycle will lead to a baby or that another test or intervention will make a difference. Yet such hope also leaves ART patients vulnerable in a variety of ways. This article argues that previous attempts to safeguard ART patients have neglected how the use of add\u2010ons in commercial ART can exploit patients\u2019 hopes. Commercial providers of ART should provide add\u2010ons only free of charge, under a suitable research protocol<\/jats:italic>.<\/jats:p>","DOI":"10.1002\/hast.1513","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T18:24:53Z","timestamp":1699986293000},"page":"30-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hope and Exploitation in Commercial Provision of Assisted Reproductive Technologies"],"prefix":"10.1002","volume":"53","author":[{"given":"Anthony","family":"Wrigley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Watts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Lipworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainsley J.","family":"Newson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/14636778.2019.1709430"},{"key":"e_1_2_9_3_1","unstructured":"We note that use of the term \u201cpatient\u201d in the context of ART is contested. Alternatives include \u201crecipient \u201d \u201cconsumer \u201d \u201cend user \u201d and \u201cwoman \u201d but these too can be problematic. In this article we use \u201cpatient\u201d to denote any person who seeks to use ART for any reason."},{"key":"e_1_2_9_4_1","unstructured":"See for example recent data from the United Kingdom: \u201cFertility Treatment 2019: Trends and Figures \u201d Human Fertilisation and Embryology Authority May2021 https:\/\/www.hfea.gov.uk\/about-us\/publications\/research-and-data\/fertility-treatment-2019-trends-and-figures\/."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex004"},{"issue":"4","key":"e_1_2_9_6_1","first-page":"241","article-title":"Add-Ons in IVF Programme\u2014Hype or Hope?","volume":"7","author":"Datta A. K.","year":"2015","journal-title":"Facts, Views & Vision in ObGyn"},{"key":"e_1_2_9_7_1","volume-title":"Pilot National Fertility Patient Survey","author":"Lensen","year":"2018"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013940"},{"issue":"1","key":"e_1_2_9_9_1","first-page":"1","article-title":"Add-Ons in the Laboratory\u201d; Harper et al., \u201cAdjuncts in the IVF Laboratory\u201d; C. A. Venetis, \u201cEndometrial Injury before IVF: Light at the End of the Tunnel or False Hope?","volume":"36","author":"Armstrong","year":"2021","journal-title":"Human Reproduction"},{"key":"e_1_2_9_10_1","unstructured":"Wilkinsonet al. \u201cDo \u00e0 la Carte Menus Serve Infertility Patients?\u201d"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2019.04.005"},{"issue":"12","key":"e_1_2_9_12_1","first-page":"1850","article-title":"Endometrial Injury before IVF\u201d; \u201cTreatment Add-Ons with Limited Evidence,\u201d Human Fertilisation and Embryology Authority; W. L. Ledger, \u201cThe HFEA Should Be Regulating Add-On Treatments for IVF\/ICSI","volume":"124","author":"Venetis","year":"2017","journal-title":"British Journal of Obstetrics and Gynaecology"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14461242.2017.1349545"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114317"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6434"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-021-10001-5"},{"key":"e_1_2_9_16_1","unstructured":"Harperet al. \u201cAdjuncts in the IVF Laboratory\u201d; Wilkinson et al. \u201cDo \u00e0 la Carte Menus Serve Infertility Patients?\u201d; Hartman \u201cTransparency of Hope.\u201d"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2018-104983"},{"key":"e_1_2_9_18_1","unstructured":"Franklin Embodied Progress."},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780197501252.001.0001"},{"key":"e_1_2_9_20_1","volume-title":"The Elusive Embryo: How Women and Men Approach New Reproductive Technologies","author":"Boden","year":"2000"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoaa059"},{"key":"e_1_2_9_22_1","unstructured":"Mayes Williams andLipworth \u201cConflicted Hope \u201d45."},{"key":"e_1_2_9_23_1","unstructured":"Franklin Embodied Progress."},{"key":"e_1_2_9_24_1","unstructured":"Ibid. 203; \u201cFertility Treatment 2019: Trends and Figures \u201d Human Fertilisation and Embryology Authority."},{"key":"e_1_2_9_25_1","unstructured":"Franklin Embodied Progress 310."},{"key":"e_1_2_9_26_1","unstructured":"Ibid. 310."},{"key":"e_1_2_9_27_1","unstructured":"Ibid. 342."},{"key":"e_1_2_9_28_1","unstructured":"Coppet al. \u201c\u2018Your Hopes Can Run Away with Your Realistic Expectations\u2019\u201d; Perrotta and Hamper \u201cThe Crafting of Hope.\u201d"},{"key":"e_1_2_9_29_1","unstructured":"Becker The Elusive Embryo 117; Copp et al. \u201c\u2018Your Hopes Can Run Away with Your Realistic Expectations\u2019\u201d; Inhorn et al. \u201cEgg Freezing at the End of Romance.\u201d"},{"issue":"2","key":"e_1_2_9_30_1","first-page":"89","article-title":"Hope","volume":"6","author":"Day J. P.","year":"1969","journal-title":"American Philosophical Quarterly"},{"key":"e_1_2_9_31_1","unstructured":"Snyder Exploiting Hope 25."},{"key":"e_1_2_9_32_1","unstructured":"PerrottaandHamper \u201cThe Crafting of Hope.\u201d"},{"key":"e_1_2_9_33_1","unstructured":"Ibid."},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/bioe.12144"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1353\/hcr.0.0053"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0002716203261781"},{"key":"e_1_2_9_37_1","unstructured":"Martin \u201cHope and Exploitation.\u201d"},{"key":"e_1_2_9_38_1","unstructured":"Martin's account offers insights into highly relevant hopeful scenarios. Snyder also uses it in his account of the basis of the exploitation of hope (Snyder Exploiting Hope) which we discuss in the \u201cHope and Exploitation in the Offer of Add-Ons\u201d section."},{"key":"e_1_2_9_39_1","unstructured":"Martin \u201cHope and Exploitation \u201d49\u201350."},{"key":"e_1_2_9_40_1","unstructured":"Ibid. 51."},{"key":"e_1_2_9_41_1","unstructured":"Lensenet al. \u201cHow Common Is Add-On Use and How Do Patients Decide Whether to Use Them?\u201d"},{"key":"e_1_2_9_42_1","unstructured":"Snyder Exploiting Hope."},{"key":"e_1_2_9_43_1","unstructured":"Ibid. 111\u201312."},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195388930.001.0001"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1494"},{"key":"e_1_2_9_46_1","unstructured":"This was observed for example byManualPerrottaandJosieHamper; see \u201cThe Crafting of Hope.\u201d"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1515\/9780691214511"},{"key":"e_1_2_9_48_1","unstructured":"Martin \u201cHope and Exploitation.\u201d"},{"key":"e_1_2_9_49_1","volume-title":"The Psychology of Hope: You Can Get There from Here","author":"Snyder C. R.","year":"1994"},{"key":"e_1_2_9_50_1","unstructured":"Martin 53."},{"key":"e_1_2_9_51_1","unstructured":"Ibid. 53 emphasis added."},{"key":"e_1_2_9_52_1","unstructured":"See for example PerrottaandHamper \u201cThe Crafting of Hope.\u201d"},{"key":"e_1_2_9_53_1","unstructured":"McGeer \u201cThe Art of Good Hope.\u201d"},{"key":"e_1_2_9_54_1","unstructured":"Wertheimer Exploitation."},{"key":"e_1_2_9_55_1","unstructured":"For example one debate is whether a randomized controlled trial is the appropriate standard; seeMacklon Ahuja andFauser \u201cBuilding an Evidence Base for IVF \u2018Add-Ons.\u2019\u201d"},{"key":"e_1_2_9_56_1","unstructured":"Ibid."},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2019.12.001"}],"container-title":["Hastings Center Report"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hast.1513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T09:11:48Z","timestamp":1702113108000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hast.1513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":57,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/hast.1513"],"URL":"https:\/\/doi.org\/10.1002\/hast.1513","archive":["Portico"],"relation":{},"ISSN":["0093-0334","1552-146X"],"issn-type":[{"value":"0093-0334","type":"print"},{"value":"1552-146X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2023-11-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}