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When the law protects embryos but harms patients

13 July 2004
Appeared in BioNews 266
Just four months after a draconian IVF law came into force in Italy, Italian politicians are already coming under pressure to amend the legislation. The new Medically Assisted Reproduction Law, which came onto the Italian statute book in March, prohibits the destruction of embryos created outside the body. This means that all embryos created during IVF (to a legal maximum of three) must be transferred to the woman's womb, thereby increasing the chance of a multiple pregnancy.

Caught out by this restriction, a young Sardinian woman (the second in two months) recently found herself having to ask a court's permission to terminate one of the fetuses in her triplet pregnancy for the sake of her and the other babies' health. As many Italian doctors were quick to point out, this woman's experience shows how the desire to protect human embryos from destruction has led to the termination of an 11-week fetus. This isn't to say that women in Italy should not have access to abortion. Rather, a law governing early human embryos should not end up forcing women - who have been through so much to get pregnant - to consider whether or not to opt for selective termination in a much wanted and planned for pregnancy.

It's not just in relation to multiple pregnancy that the Medically Assisted Reproduction Law could have a damaging effect. Because a maximum of three eggs can be collected from a woman undergoing IVF and all resulting embryos must be replaced in her womb, the chance of success of an IVF cycle is likely to be reduced. In countries where there is no restriction upon the numbers of embryos created, doctors and embryologists are able to choose the number and quality of embryos most likely to result in a pregnancy for that particular patient. Italian IVF doctors, however, are obliged to replace all embryos, regardless of their patient's best interests. And with no embryo freezing permitted, the Italian law obliges women to undergo a fresh cycle of IVF treatment - with the ovarian stimulation drugs it entails - each time, instead of using spare embryos that could have been frozen after a previous cycle.

Sovereign states are entitled to prohibit whatever research or clinical practice that they see fit. But when such prohibitions leave patients with less safe and less effective techniques as their only options, these states are surely shirking their responsibilities to patients. The message from the Italian government seems to be that the survival of all human embryos is more important than the safety and wellbeing of its infertile citizens.

Juliet Tizzard is the Founder of BioNews and was formerly Director of the charity that publishes it, the Progress Educational Trust (PET). She is coauthor of Key Issues in Bioethics (buy this book from Amazon UK) and Designer Babies: Where Should We Draw the Line? (buy this book from Amazon UK).

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