Views expressed by the general public on this issue have been mixed. Many condemned the Church's intervention in what they see as a personal issue. Others feel the outcome reflects the feelings of Italians in general. Since the collapse of the referendum I have read several comments in the media varying in opinion. These range from: 'Why do people insist on making more babies when there are so many here already that need homes and love, we should be reducing the population, not increasing it. Kick the fertility habit! Be creative, not reproductive!' and 'As anyone who has had problems conceiving knows, the trauma that it causes is horrific and my heart goes out to all couples going through fertility treatment' (from BBC News Online's 'Have Your Say').
However, I have heard directly from patients in Italy, specifically from our sister organisation in Italy, 'Cerco un Bimbo', and, as many readers of BioNews will expect, they are angry and devastated by the collapse of the Italian referendum. This law means that patients in Italy are not permitted to have egg or sperm donation, are only allowed to create and transfer three embryos in any one treatment cycle, and cryopreservation is forbidden. This law literally forces patients to travel abroad thus escalating 'fertility tourism', increases the risks of multiple births for patients and the resulting children, and removes choice from patients.
Let me take those three decisions in turn. First, the law forbidding egg or sperm donation. There are several reasons why couples may need gamete donation in order to have a family. Some could be forgiven for thinking it is only those couples where the woman has decided to pursue a career, is over 40 and the quality of her eggs is poor. But in fact there are other reasons such as premature menopause and infertility (both male and female) brought on by cancer treatment. Why should any of these couples be denied the chance of a family?
Doctors are concerned that the requirement to transfer three embryos, if they are created, in any one treatment cycle, whatever their quality, together with the ban on cryopreservation, reduces the chance of success for couples in Italy. Couples are forced to undergo a higher number of treatment cycles in order to conceive - cycles which have potential risks such as ovarian hyper-stimulation syndrome (OHSS), a very rare but potentially fatal condition. The mandatory implantation of three embryos also increases the risk of a multiple pregnancy, again with potential health consequences for the mother and the potential children.
Infertility patients are generally considered to be one of the most informed groups of patients and it is obvious therefore they too will have these concerns. My organisation, Infertility Network UK (I N UK), is a member and the current Chair of the European Infertility Alliance (EIA). The EIA is made up of organisations of those affected by fertility problems. At a meeting of its members, held before the annual iCSi (International Consumer Support for Infertility) conference in Copenhagen, prior to the ESHRE Congress, all members agreed that the aim of the EIA was to promote equity of access to high quality, affordable infertility health care services and the involvement of patients in all aspects of treatment and public policy decision making in Europe - including Italy.
One point appears to have been overlooked in all the media and political coverage of this issue - namely the devastating emotional effect that this law may have on couples. I hope that the many people affected by the outcome of the referendum in Italy - couples whose lives have been put on hold for years whilst they try to have a baby and whose health is being put at risk by this legislation - are provided with the emotional support they need and deserve.