Of life - and women - at all ages

I read with interest the letter Life Without Fertilisation by Martin Schranz, an old friend and classmate of mine at school.

First of all, I would like to thank Dr Schranz for elaborating on the discussions and providing me an opportunity to further discuss these since time was limited on the TV show Bondiplus.

Dr Schranz is completely right that according to most of the research, both the pill and the coil are abortive in many cases, although it has often been argued to me by obstetricians that with the modern hormone-impregnated versions of the coil this may not be the case.

I felt that point did not come across accurately during that part of the discussion and I should qualify my statement that I have no problems with barrier methods of contraception (such as the condom) which are also the only safe ones to protect against sexually transmitted disease to some extent.

The two other points are fine discussions of science and have, in my opinion, absolutely no bearing on the moral arguments, but again in both of these, Dr Schranz is largely correct. I doubt this following will mean much to many as it is the kind of detailed scientific discussion not usually included in newspapers but here goes.

Yes, Dr Schranz is correct that influences on each of the individual gametes (ovum and sperm cells) which on combination make up a new human life may be influenced earlier on, through processes such as genetic imprinting and other epigenetic mechanisms. It is nowadays recognised that even the grandchildren of females exposed to diethylstilboestrol in utero have a likely increased cancer risk. Any mutation carried in the cells of not only my grandparents but even my great-great-great grandparents can be passed on to many generations of offspring (and so can other non-harmful traits). This can account for what in genetics is called the founder effect and is particularly evident in small isolated countries like ours.

On the more contentious point of human life without fertilisation, I disagree. This is not to say that some kind of structure made from human cells cannot develop without fertilisation - it can - Dr Schranz is right here. Medical conditions called ovarian teratomas (a tumour) and hydatiform moles (a pregnancy made up only of a placenta-like structure) are two examples. Neither will however ever develop into anything like a child. Due to this, research into artificial non-fertillised embryo-like structures (making artificially parthenogentic zygotes) is in fact being touted as a method of making morally neutral embryonic stem cells. While this may well be the case, making pluripotent stem cells for each of us out of our own adult cells is probably only a short time away, if one looks at research from Dr Yamanaka's lab in Kyoto, Japan.

Rather than delve into high-tech scientific discussions on issues most of the general public will not understand, I personally would appreciate if Dr Schranz will weigh in with his own considerable medical expertise - medical imaging - on the issue of mammary screening programmes which have even reached the heady heights of the budget discussion.

According to a recent study (2007) reviewed in Evidence-based Medicine, mammography cannot be shown to have significant effects in reducing mortality rate in women below 50 years of age. A recent publication (April 2007) by the American College of Physicians (after reviewing 117 studies in the area) suggests that there is not enough evidence to recommend in favour of or against routine breast cancer screening between the ages of 40 and 49 but that each patient's cancer risk should be assessed with their GP and a decision should be based on this.

Luckily, the screening programme in Malta has been recommended in the budget for those over the age of 50, so that some benefit is likely to come out of it, however, small. However, public discussion of the issue for younger women would seriously affect the financial profits of numerous private medical concerns in Malta. So I would honestly like to hear an expert publicly voicing his/her opinion on a subject of at least as much importance to women as birth control.