The parliamentary Social Affairs Committee has ended its discussion on IVF, which has been going on since March, without resolving the key issue under scrutiny and MPs failing to reach a conclusion on whether egg freezing is preferable to embryo freezing.
In its final session this week, the committee, chaired by Nationalist MP Edwin Vassallo, agreed to pass on the transcripts of the lengthy discussions, including the expert opinions, to the government without deciding whether embryo freezing should be substituted by egg freezing (oocyte vitrification) or, if allowed, under what circumstances.
The decision will have to be taken by the government while drafting legislation to regulate IVF.
Government sources said the drafting had gone “beyond the initial stages” with input from different ministries. In fact, Prime Minister Lawrence Gonzi last Sunday hinted that the law would not favour embryo freezing, insisting that egg freezing helped avoid the problems of conscience brought about by embryo freezing.
During the debate at the Social Affairs Committee over the past few months, MPs inched closer to consensus that embryo freezing should be permitted but differences emerged between experts over when it should be allowed.
Embryo freezing was thrust onto the national agenda after a Select Committee chaired by Nationalist MP Jean Pierre Farrugia last year unanimously recommended it be allowed as part of the IVF process.
Nationalist MP Frans Agius and Labour MP Michael Farrugia were members of the Select Committee that had, over the course of nine months, listened to expert opinion and produced a detailed report on the matter.
However, Health Minister Joe Cassar had reacted negatively to the proposal, insisting that egg freezing was a preferable option.
His comments and those of a handful of doctors, calling themselves Professionals Against Embryo Freezing, re-opened the discussion and the Social Affairs Committee was tasked to evaluate egg freezing as an alternative.
During committee meetings, Jean Pierre Farrugia and Michael Farrugia stood solidly behind their report, insisting that, although embryo freezing should not be the rule of thumb, it did not make sense to have a law that was too specific and restrictive.
In submissions to the committee, Mark Brincat, director of gynaecology and obstetrics at Mater Dei Hospital, had said embryo freezing and oocyte vitrification were not mutually exclusive. He insisted that embryo freezing was necessary to reduce the risk of multiple pregnancies and give couples the best possible chance of success.
Prof. Brincat reiterated what he had told the Select Committee last year that the target should be to implant two embryos and reduce the risk of multiple pregnancies.
However, to achieve this, a higher number of eggs had to be fertilised because natural wastage always happened. “If we fertilise four eggs to get two embryos but end up with three fertilised eggs instead, what shall we do with the third one? Shall we discard it or forcefully implant it in the woman? Embryo freezing is a fallback option in this case,” Prof. Brincat had said in a statement that put him on a collision course with the doctors opposing embryo freezing.
Despite their opposition, the doctors admitted that embryo freezing would have to be allowed in certain cases of “a grave nature” but in their final submission last week their legal consultant, Tonio Azzopardi, hinted at a very restrictive law that would not make provisions for the situation cited by Prof. Brincat.
It was this stickling point that remained unresolved and which is now back in the government’s court.
Select Committee recommendations
The Select Committee on medically assisted procreation chaired by Nationalist MP Jean Pierre Farrugia last year made a series of recommendations intended to resolve the main sticking points left open by the 2005 Puli report.
• Heterosexual couples in stable relationships and not just married couples should be eligible for medically assisted procreation treatment. This recommendation may be changed to married heterosexual couples after the passage of a divorce law, according to Jean Pierre Farrugia, although Michael Farrugia insists the wording should remain the same.
• An autonomous authority on the same lines as the Human Fertilisation and Embryology Authority in the UK should be set up to issue licences to clinics, draw up standards of best practice, collect information from clinics and certify the eligibility of couples for IVF treatment.
• Infertile couples should have the possibility of adopting frozen embryos that are unclaimed by their parents.
• The donation of sperm and ova by third parties will not be permitted.
• The law should allow unused embryos to be frozen for future use by the couple. The Health Minister has said egg freezing is a preferred option with embryo freezing only used as a last resort for grave cases, a situation that is yet undefined.
• IVF treatment should be financed by the state to make it accessible to all infertile couples.
ksansone@timesofmalta.com