Statutory Requirement and Terms of Reference
ACART is established under the Human Assisted Reproductive Technology Act 2004 (the HART Act). Section 35 sets out ACART’s functions. Under section 35 (2) ACART is required to monitor the application, and health outcomes, of assisted reproductive procedures (ARPs) and established procedures (EPs); and developments in human reproductive research. ACART is also required, under its Terms of Reference, to monitor the decisions of the Ethics Committee on Assisted Reproductive Technology (ECART).
ACART is not required to monitor activities that are prohibited by the HART Act, nor does it conduct formal horizon scanning. Formal horizon scanning would require extensive analysis of the current literature about and practices in assisted reproduction, and ACART is not resourced to carry out such intensive scanning. Nevertheless, its monitoring activities mean it remains current with emerging literature and practices.
Monitoring the application and health outcomes of ARPs and EPs
ACART has the New Zealand-specific Australia and New Zealand Assisted Reproduction Database (ANZARD) report produced and published annually. This report provides data and analysis on the uses and outcomes of assisted reproductive technology in New Zealand, and is part of how ACART monitors the application and health outcomes of ARPs and EPs. The first New Zealand-specific report drew on 2009 data, and the annual publication of reports means ACART is able to observe and monitor trends occurring in the use of ARPs and EPs.
New Zealand and Australian fertility clinics submit data to the ANZARD database. The data is for pregnancy and birth outcomes, but does not include health outcomes in the post-natal period and beyond.
As part of ACART’s monitoring of the application of ARPs, its annual report includes data about ECART applications in the previous year. ACART further monitors the health outcomes of ARPs by keeping up to date with relevant research, including research specific to New Zealand and international research.
Monitoring the decisions of ECART
ACART monitors ECART’s decisions on the applications clinics make to carry out ARPs, to ensure they fall within the guidelines intended by ACART. While ACART does not act as an appeal body, it informs ECART if it considers a decision does not fall within the guidelines. The information that comes out of this process helps ACART’s further development of policies
Monitoring developments in emerging ARPs and human reproductive research
ACART carries out several activities to monitor developments in emerging ARPs and human reproductive research. Members and the secretariat find and share with each other relevant media and academic journal articles. The secretariat distributes Bionews articles and Human Fertilisation and Embryology Authority updates with committee members. Members and the secretariat also recommend relevant books to each other, attend and report on conferences, and consider what is happening in this field in other jurisdictions.
ACART is also aware that, increasingly, developments in social attitudes and trends are broadcast in non-scientific forums.
The area of human assisted reproductive technology advances rapidly. In order to have a full and up-to-date overview, ACART watches what is happening both in New Zealand and internationally.
ACART monitors topics in the areas of both biomedical science and social science, as well as law reform that may have an impact on ART.
The biomedical science topics it monitors include current best practice in fertility treatment, reproductive technologies, biological and reproductive science, genetics (including how genes work, testing/screening, replacement/manipulation), and outcomes of assisted reproductive procedures.
The social science topics it monitors include relationship (family) studies, psychology, and ethics (including risk, both in theory and in practice).
ACART also monitors social attitudes towards assisted reproductive technology, considering changes and trends, including the use of social media. It also considers law and case law, and the implications these have for developments in the use of assisted reproductive technology.
The importance of monitoring for ACART’s work
ACART’s monitoring role enables it to be well informed as it carries out its two key functions. These are providing independent advice to the Minister of Health, and issuing guidelines to ECART on procedures and research requiring case-by-case approval.