For well over two decades, under the watch of successive Nationalist governments, IVF procedures in Malta went on completely unregulated. It was only during the dying breaths of Gonzi’s last term in office, late in 2012, did the law finally kick in.
The irony of it all. The dragging of feet by two PN prime ministers and a prospective leader, presumably for ‘religious’ reasons, resulted in decades of a complete free-for-all about the most precious of rights – the right to life. Claims and counterclaims by doctors and practitioners of less than best practice, at the time were common.
Having said this, and to be fair, the legislation enacted in 2012 was a good start. At least, a legislative framework was put in place. Now, however, the time has come to take it further.
What amendments to current IVF legislation did I, on behalf of this government, propose in Parliament yesterday?
For starters, at present, a prospective parent is defined as the male or female in a stable heterosexual relationship. With these amendments, this discrimination in the provision of medical services on the basis of gender orientation will be eliminated.
The treatment shall be available to couples of any sexual orientation as well as to single people wishing to become parents.
These amendments will also make it possible for a woman and a man to donate eggs and sperm respectively to be used by prospective parents.
At the same time, we have rigorously ring-fenced this new right.
Siblings or directly related individuals will be barred from making egg or sperm donations. Donors have to be 18 years old or older and female donors have to be under 36. In addition, a donor can only donate once. On the other hand, women who receive donated ova will remain eligible for IVF procedures until they are 48 years old, an increase of five years.
Then there’s the delicate issue of anonymity. The identity of the donor shall remain anonymous, except in the case of direct donations. The medical records of an anonymous donor, however, can be made accessible to offspring who are 16 years of age and older. If there is a medical need, an exception can be made and the records made available earlier.
The current law allows for the possibility of triplets. These amendments seek to avoid the inherent danger of this eventuality to both the mother and the foetuses.
Altruistic surrogacy – the process by which a woman is implanted with an embryo from prospective parents – should be decriminalised
To limit the number of embryos implanted to two, without significantly decreasing the success rate of IVF, we need to introduce embryo freezing.
On the other hand, to make sure that all embryos are treated with dignity and given the possibility to develop, we are coupling embryo freezing with the concept of embryo adoption.
We are proposing that when a prospective parent gives permission for frozen embryos to be adopted, three eggs can be fertilised in the first IVF cycle and five in subsequent ones. On the other hand, if a prospective parent is against embryo freezing and adoption, only two eggs are allowed to be fertilised in the first and all subsequent cycles.
In all circumstances, implantation is to be limited to a maximum of two embryos – to avoid the risk of triplets.
This Act will be establishing that embryos not implanted will be given up for adoption, a process which will be the responsibility of the Embryo Protection Authority, which will keep a register and scrutinise applicants for eligibility.
The implantation of embryos from different persons in the same cycle will not be allowed. Facilities for cyro-preservation or the freezing of embryos shall be licensed and a prospective parent will sign a five-year contract with one of them.
The contract will be renewable until the age that the parent can use the embryo.
The Embryo Protection Authority will keep a register of the frozen embryos. Pro-spective parents may choose not to have recourse to embryo freezing, in which case only two eggs may be fertilised in each cycle.
We are trying to do more with this proposed legislation. We believe that altruistic surrogacy – the process by which a woman is implanted with an embryo from prospective parents – should be decriminalised.
Surrogacy for profit shall remain illegal.
In the coming days we will be issuing a public consultation document precisely on these points. In addition, the use of any technology to discover, pre-implantation, whether an embryo has chromosomal defects will not be allowed and neither will the selection of embryos according to gender. Cloning will remain illegal.
These are the proposed changes to the law governing IVF. It is my sincere hope that they will be debated thoroughly, in a spirit of goodwill and away from all types of extremisms. This is not run-of-the-mill legislation. It addresses one of the most powerful forces in human nature – the will to procreate and have a family. I trust that all of us shall rise to the occasion.
Chris Fearne is Deputy Prime Minister.