Italy Daily
International Herald Tribune
July 18, 2002

New law, but little order, on fertility frontier
Comment: Italian IVF bill would endanger women, encouraging unproven techniques and risky multiple pregnancies. Science and safety should direct the legislation – not the moral musings of the Church

"The long-awaited law
appears more harmful
than helpful, driven by
the Church idea that
suppressing a human cell's
right to life is immoral"

Italy has long been known as the "Wild West" of infertility treatments: No age limits, background checks or industry regulations hampered women seeking assistance. "Reproductive tourists" flocked into the country, taking advantage of the lawless climate.

After 20 years of skirting the issue, the government decided it was time to address this baby boom. So far, so good. Why let rogue clinics set the pace, turning a scientifically-advanced nation into a three-ring circus? But this burst of common sense faltered. The long-awaited law appears more harmful than helpful, driven by the Church idea that suppressing a human cell's right to life is immoral.

The European Society of Human Reproduction and Embryology blasted the legislation which cleared the lower house last month and soon goes to the Senate for final approval, claiming it would encourage unproven techniques and risky multiple pregnancies. The accepted method of treatment begins with fertility drugs, which encourage a large crop of eggs. Doctors then harvest and inseminate the eggs, creating embryos. One or two embryos are implanted, while the rest are frozen for future use, should the process fail the first time around.

The pending legislation forbids the storage of fertilized embryos. Sperm and eggs could be kept separately – as this does not yet constitute "human life." But ice often damages the delicate egg tissue, which can cause genetic damage.

Only 30 babies have been born worldwide using frozen eggs. A team from the University of Bologna recently improved the process, but experts say the treatment won't be reliable for at least five years. Nevertheless, politicians are endorsing this experimental technique. Taking the moral high ground, they choose to ignore scientific warnings, like those of ESHRE Chairman Hans Evers: "It is unethical to subject women to a procedure that is of low efficacy and the safety of which is still a concern."

The other option is for women to undergo a lengthy egg harvest each time. Not only is this painful, but overexposure to fertility drugs can cause further health problems. Again, the message is clear: The sanctity of a two-celled embryo is more precious than the health of an adult woman.

It gets worse. The bill insists that if three embryos are created, all must be implanted in the womb. This increases the chance of triplets, which endangers the mother, as well as the children.

Disease, disability and birth defects accompany multiple births. Triplets have 47 times the normal risk of a child with cerebral palsy. And the infant mortality rate soars. Nine babies were born in Australia in 1971 – the largest multiple birth on record – but none lived longer than six days.

Italy already has an embarrassing number of multiple births, as doctors try to get results by overloading women's bodies with embryos, ignoring the recommended limits. Here we have triplet rates of 7 percent compared to 0.8 percent in northern Europe. In fact, recent reports indicate that less is more. Scandinavian doctors usually implant just one or two embryos – and achieve greater success.

"In Sweden, doctors never transfer three or more embryos at one time, yet we have one of the highest pregnancy rates per transfer in Europe at 36 percent," Karl Nygren from Stockholm said at an ESHRE conference. "In light of these findings, it seems doubly unfortunate for Italians to be proposing a retrograde step which could result in women becoming pregnant with triplets, endangering the safety of mothers and babies. Once Italian women realize this, they will go to other countries for treatment – a 'womb drain' that would reverse the current direction in reproductive tourism."

We can only hope this dangerous bill stalls in the Senate. Infighting blocked previous proposals – to impose jail terms on rogue doctors, ban surrogate motherhood and stop elderly women from undergoing fertility treatment – leaving the fertility industry wild and free for the last 20 years. The need for laws – considered, rational laws – is clear, if only to reign in cowboy operators like Severino Antinori; the Rome-based doctor is infamous for his intention to clone a human. Other clinics permit families to "weed out" embryos of an undesired sex and controversially implant women in their late-50s.

It's time for law and order on the Fertility Frontier. But science and safety should direct the legislation – not the moral musings of the Holy See. After all, only 25 percent of Italians attend Mass regularly, and most cheerfully ignore the papal decree against birth control. So why let the Church protect an embryo at a woman's expense?

A country that venerates le mamme shouldn't pass laws that threaten them.

Amanda Castleman is a freelance journalist based in Rome, specializing in women's issues. Comments may be addressed to

"A 'womb drain'
would reverse the
current direction in
reproductive tourism."

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