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Italian reproduction law increases multiple pregnancies

16 July 2007
Appeared in BioNews 416

The Italian health minister, Livia Turco, has publicised an official report examining data on assisted reproduction following the introduction of a new restrictive law in 2004. The study has found that a reduction in the success rate of procedures and an increase in multiple pregnancies have been the result of the new rules.

The law was approved by the then right of centre government, and prescribed that only three embryos could be created in each IVF cycle, that embryos could not be frozen, and that all embryos must be implanted in the womb, as well as banning PGD and the use of donated gametes.

The results of the study show that in the years between 2003 and 2005, since the introduction of the legislation, centres offering assisted reproduction found a 14.5 per cent decrease in the number of pregnancies for every 100 eggs extracted. There was also a decrease in the number of pregnancies per embryo transfer, from 27.6 per cent in 2003 to 24.5 per cent in 2005.

In addition, the rate of negative outcomes rose from 23.4 per cent to 26.4 per cent. The number of multiple births increased from 22.7 per cent to 24.3 per cent, due to the usual practice of fertilising three embryos, which then must be implanted in the womb.

Dr Giulia Scaravelli, head of the registry at the Instituto Superiore di Sanita, stated that although the findings were significant, the scientific value of the report was not totally satisfactory, due to the lack of follow up data. Due to Italian privacy laws, for example, the researchers were unable to find out how many women repeat cycles of IVF before becoming pregnant or giving up. Dr Scaravelli explained that they would attempt to overcome the limits of the study by asking patients to complete a voluntary survey on each cycle. She stated that 'this way we also hope we'll have a much better follow-up on the outcome of the pregnancies, so that we'll have a less approximate measure of the live birth rates'.

One effect of the restrictive legislation is that couples have travelled abroad to seek IVF treatment or PGD. In 2006, the Reproductive Tourism Observatory estimated that the number of couples seeking treatment abroad had increased four-fold in the wake of the introduction of the measures. However, legal challenges to the ban on PGD in the Italian courts have so far failed.

SOURCES & REFERENCES
Restrictive law on reproduction increases multiple pregnancies
The British Medical Journal |  14 July 2007
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