6 Ethics for Embryologists 145studies of what it meant to be an ‘IVF baby’ was published. This was a
surprisingly long twenty-one years after the birth of the first baby con-
ceived through Australian IVF treatment (Hewitt 2001 ). Prior to that
study, no one had been interested in investigating such experiences.
Similarly, on an international level, the practice of IVF is not routinely
regulated and it is frequently astonishing to Australasian students to
discover that a wealthy country such as the USA has no federal regula-
tion of the practice of IVF. Instead, practices such as closed donations,
imprecise and meagre background documentation of samples, and pro-
cesses such as multiple embryo implantations may occur with impunity
in certain clinics.
Religious opinions regarding HART are a further source of ethical
complexity (Manninen 2012 ). There are, for example, those ingenious
users of the services who, if sufficiently wealthy, have been able to trav-
erse international borders (Pennings 2002 ) to obtain the ethical and
religious regulatory environment that matches their desires. Clients may
also take selective readings of religious doctrine in order to authorise
otherwise forbidden HART outcomes (Thompson 2006 ; Inhorn 2015 ).
Italy, prior to the passage of the highly conservative 2004 Act regulat-
ing human biotechnology and HART, provides an example of the com-
plicated manoeuvring that occurs between national policies, professed
religious belief and the behaviour of consumers (Engeli and Rothmayr
Allison 2015 ). Private clinics at the time had extremely high uptakes
of IVF, including some of the least internationally well-regarded proce-
dures, such as implantation of post-menopausal women (The New York
Times 1993 ; Antinori et al. 1993 ). This was despite a strong national
adherence to Catholicism, a doctrine that has always adopted an adver-
sarial tone to HART. In comparison, New Zealand is a nation with low
levels of formal religious affiliation. Complex ethical concerns in this
locale are instead entwined with ideals of secular service provision.
In New Zealand, the practice of providing HART is regulated
through the HART Act (2004) which establishes the HART Order
(2005), itself a legislative instrument. The order sets out the array
of IVF techniques that are established procedures, that is, able to be
offered and undertaken without any further ethical approval. New
Zealand clinics (which are mostly privately owned) must and do