Alarm at birth of so many triplets

The birth of five sets of triplets in the span of a month is “very alarming” and highlights the urgent need to regulate in vitro fertilisation and other forms of assisted procreation, according to parliamentary Bioethics Committee chairman Michael Asciak.

Dr Asciak said his research had shown that over the last 10 years an average of 2.5 sets of triplets each year had been born from IVF, artificial insemination or hyper stimulation.

“It was, therefore, very alarming that in the span of one month there have been five sets of triplets... One questions how many fertilised embryos are being inserted into women?” he said.

Dr Asciak, a Nationalist MP, also questioned whether women were being counselled properly to make an informed decision before subjecting themselves to assisted procreation.

Mater Dei Hospital’s premature babies’ ward – the Neonatal Paediatric Intensive Care Unit – is currently overcrowded due to multiple births resulting from IVF.

Over the past few weeks five women have given birth to four sets of triplets and a pair of twins. Another mother is expected to deliver a fifth set of triplets in the coming days.

Figures obtained from the National Obstetrics Information Systems show that last year five sets of triplets were born until November compared to three sets born in 2009 and four the previous year.

Dr Asciak said one of the problems was that a foreign embryologist visited Malta once every three months to implant the fertilised eggs into women. This meant these women were batched and then gave birth about the same time, translating into an overload on the hospital’s maternity services.

He insisted it was important that any regulations ensured implantations were staggered to avoid this situation of overcrowding.

Dr Asciak said ideally not more than three fertilised embryos were implanted at one go into a woman. However, statistics showed there had been quadruplets born as a result of assisted procreation which meant at least four had been implanted.

He pointed out that private clinics were not doing anything illegal as the country did not yet have a law regulating IVF and assisted procreation. The bioethics committee submitted a draft law to then Health Minister John Dalli over a year ago.

The draft law said doctors would be required to inform couples about the risks of IVF. It recommended fertilising up to three eggs and did not allow embryo freezing.

This contrasted with the more recent recommendations made by another parliamentary committee, on assisted procreation, that recommended embryo freezing last October.

The overcrowding at NPICU came to light on Saturday when members of the committee on assisted procreation visited concerned doctors at the ward.

Nationalist MP Jean Pierre Farrugia and the other two committee members – Labour MP Michael Farrugia and Nationalist MP Frans Agius – stressed the need to regulate IVF and introduce the option of embryo freezing – in line with recommendations made by the committee last October.

As a result of the lack of regulation on assisted procreation, they said, there were currently 28 babies at NPICU, which has a bed capacity of 18.

An inquiry has been launched into the way the ward is being run after two newborns, from a set of triplets, died from an infection contracted from their mother during birth.

It is not yet clear whether overcrowding may have been a factor in the infection or whether the mother entered hospital with the infection or contracted it there.

The health authorities have acknowledged there is a problem of overcrowding due to the multiple births adding that babies were being given the best care possible and there was no cause for alarm.