A law regulating medically assisted procreation should allow the genetic screening of embryos before implantation for couples suffering hereditary diseases, according to an Italian expert.

The report by Parliament’s select committee on medically assisted procreation does not mention genetic screening of embryos but advocates the screening of eggs and sperm before fertilisation to ensure that frozen embryos are healthy and could be adopted if their parents give them up.

However, Luca Gianaroli, who heads the European Society of Human Reproduction and Embryology, insists that, while the screening of eggs is possible, not the same can be said of sperm.

Dr Gianaroli was one of the medical experts consulted by the select committee earlier this year. When contacted yesterday he said the recommendation to freeze embryos was an important positive step but it might be problematic if not accom-panied by provisions allow-ing pre-implantation genetic screening.

Sperm cannot be screened for genetic disorders and to have a complete picture doctors would have to screen embryos. “The recommendation discriminates among citizens on the basis of gender because genetic disorders from the mother’s side can be identified by screening the egg but it will not be possible to identify a similar gen-etic disorder if it comes from the father’s end,” Dr Gianaroli said.

He explained that some medical conditions such as gen-tic translocation that prevent-ed a pregnancy from continu-ing were found in women and men.

“Screening the ova will only identify the condition if it is linked to the mother and this is unacceptable because it lim-its the possibility for those couples who have such a problem,” Dr Gianaroli said, insisting that genetic screen-ing of embryos should be made according to estab-lished protocols and could be limited to an agreed list of pathologies.

“It will not interfere with the life of the embryo because in this case the embryo would still die eventually,” he added.

The select committee ruled out donation of gametes by third parties in a bid to encourage infertile couples to adopt frozen embryos instead.

Dr Gianaroli said donation of gametes was important to give sterile couples a chance to conceive, however, he highlighted two issues which may be problematic in a small country.

“In a small population like Malta anonymity may be hard to guarantee and there is a higher risk of consanguinity. EU data shows that the number of people who need egg and sperm donation is limited but if the government is keen to offer this possibility while eliminating the risks it should be willing to reimburse couples who travel abroad to make use of such treatment,” he said.

The select committee opted for embryo freezing to limit the number of fertilised eggs that are transferred to the woman’s womb and so reduce the risk of multiple pregnancies and avoid repeatedly having the woman being stimulated with hormones to harvest the ova.

The parents of frozen embryos can give them up for adoption, as opposed to donation, if they do not or cannot use them.

But for Josie Muscat, who heads the only clinic in Malta that provides in-vitro fertilisation treatment, the recommendations give rise to ambig-uity.

“I cannot understand the distinction between embryo adoption and donation. Within this context I fail to see the reasons why sperm and egg donation is not recommended because there are cases of sterility where the couple would need to have either of the gametes donated,” Dr Muscat said.

Embryo freezing was also a problem, he added, unless the legislator took into consideration what would happen to unclaimed embryos.

“What will I do with frozen embryos that nobody claims? Who will shoulder the cost of keeping them frozen? Shall I bring them out to thaw and die, as happens abroad?”

According to Dr Muscat, the average cost of IVF treatment in Malta, including medication, is about €4,200.

“A lot of fuss is being made on control but what nobody has said is that most gynaecologists advise their patients to undertake IVF treatment abroad at a cost that is much higher. We are described as cowboys but our success rate is very high,” Dr Muscat said.

Embryo donation is allowed in a majority of EU countries except Austria, Italy, Lithuania, Portugal, Slovenia and Sweden.

Sperm and egg donation is ruled out in Italy while Austria and Germany do not allow the donation of ova. In most other EU countries sperm and egg donation is allowed.

The issues linked to assisted procreation are rife with ethical and moral considerations even though the select committee’s brief was to treat the subject from a medical and legal perspective.

Reacting to the recommendations, pro-life lobby group Gift of Life yesterday hit out at the report’s conclusions, insisting embryo freezing was “unethical and inconsistent with a pro-life culture”.

“Embryo freezing constitutes a grave offence against human life in its most fragile stage of development and is morally offensive,” it said, insisting the report failed to address the predicament of being faced with “masses of excess embryos” in storage facilities.

To date, no country had found a solution for the serious ethical problem of what to do with excess frozen human embryos, the lobby group said, urging MPs to reject the recommendations.

However, the select committee’s chairman, Nationalist MP Jean Pierre Farrugia defended the proposals, insisting medical experts consulted by the committee were unanimous on the medical benefits of embryo freezing.

“In 2005, even the Maltese Paediatric Association approved a resolution calling for only two embryos to be transferred to the woman to reduce the risk of multiple pregnancies that can endanger the lives of children. In this eventuality, rather than discarding extra embryos, they should be frozen,” Dr Farrugia said.

He quoted submissions made by Fr Peter Serracino Inglott that embryo freezing could not be equated to the killing of an embryo.

“Fr Serracino Inglott had argued that he could not see why embryo freezing should be banned by the law,” Dr Farrugia said.

In his submissions to the Social Affairs Committee that discussed assisted procreation, Fr Serracino Inglott had said: “It is true that the embryo is being put in a condition where it may degenerate over a period of time and so life would be put in danger but there is no absolute obligation to preserve life.”

ksansone@timesofmalta.com

Sign up to our free newsletters

Get the best updates straight to your inbox:
Please select at least one mailing list.

You can unsubscribe at any time by clicking the link in the footer of our emails. We use Mailchimp as our marketing platform. By subscribing, you acknowledge that your information will be transferred to Mailchimp for processing.