The most complex problems and negative aspects of embryo freezing are of a legal nature, with split couples entering into acrimonious battles over their ownership, according to the director of Italy’s Infertility and IVF Centre, Eleonora Porcu.

Such legal problems were shared worldwide while the ethical, religious and moral issues varied, said the assistant professor at the University of Bologna, pointing out no court was comfortable deciding on the matter.

But the alternative – the preserv-ation of the female egg, instead of the embryo, considered to be the first cell of a human being – elimin-ates the legal and ethical problems.

The female gamete belongs to the female, as opposed to the embryo, which belongs to both husband and wife, she explains.

Cyropreservation – the preserv-ation of the female egg, using low temperatures, also known as oocyte vitrification – was only introduced three years after embryo freezing in 1986 and is no innovative technique. The distinction – apart from the ethical issues – is that embryo freezing is more common because it is “more convenient”, “easier” and “less time-consuming”.

But the “invaluable advantage” of oocyte preservation, which avoids having several excess embryos through the selection of the optimal eggs and the insemination of only a few, lies in the lack of ethical and legal issues, Dr Porcu says.

Other advantages of oocyte preservation are that women with fertility problems would not need to be “dangerously” hyperstimulated often, while young cancer patients, undergoing chemotherapy that can destroy their eggs, can have a chance to get pregnant later in life.

Dr Porcu is, in fact, responsible for two births two years ago to women who had ovarian cancer – the first in the world.

From her experience in the field, she does not subscribe to the argument that it is only through the production of many embryos that the best can be chosen and the remainder stored for future attempts.

For Dr Porcu, good results depend on excellent standards, including the training of embryo-logists and doctors, and the use of top-quality materials, to select the best oocytes instead of embryos.

Her advice to the government in the eventuality that in vitro fertilis-ation is offered on the national health service is to take advantage of the fact that it can draw on the expertise of those who have been using these techniques since the 1980s.

“The first thing it needs to do is learn the best way of doing IVF. Any sort of experimental approach should be avoided and local embryologists and doctors must be well trained. There are centres where they can do this, including ours, which has the most long-standing experience in oocyte preservation in the world and has even taught the US.”

However, not all centres in Italy had excellent standards, Dr Porcu maintains, and that was why its mean result is lower than Europe’s, “not because the law prohibits embryo freezing”.

As to why the technique of oocyte preservation is not the obvious choice, given its benefits, Dr Porcu says IVF the world over is driven by money and business. Having more embryos also opens up the possibility of their manipulation, which again leads to more money, and Dr Porcu believes “business is not good medicine”.

She is not surprised that the technique may still be questioned in Malta, saying it happened in Italy once the restrictive law against embryo freezing, manipulation and gamete donation was passed in 2004.

At the time, she was “scandalised” that many politicians opposing it did not have a clue of what an oocyte was.

Many centres fought it too, she says. But a referendum to abolish the law a year later did not pass.

The second requirement for Malta involved the education of its citizens on how to use and protect their fertility, adds Dr Porcu, who has been engaged by Italy’s Health Ministry on an initiative that aims to help women avoid “falling into the tunnel of assisted procreation”.

It is the last chance and Dr Porcu insists mothers should look after their daughter’s fertility from a young age, taking them for check-ups. Even GPs may not be up to scratch on fertility issues and pathologies that cause damage, she maintains.

Dr Porcu was in Malta over the weekend to participate in an event by the lobby group Professionals Against Embryo Freezing, set up in January.

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