As a father, husband, doctor, psychiatrist, but particularly as a politician, I strive to hold strong to my own principles and beliefs. When challenged with political decisions, I cannot move away from my beliefs and principles and constantly seek to marry these with our mission to address the common good of our society, our population, our nation as part of the wider world.

My heart goes out to all those couples who have wished to conceive a child but have faced difficulties in doing so. Fertility difficulties may be caused by the woman, the man, or both. Irrespective of where the difficulty comes from, medically-assisted reproduction has helped many couples. This assistance may be through fertility medication or assisted reproductive technology (ART) such as in vitro fertilisation (IVF).

Couples facing challenges to conceive a child may attempt to go through various avenues. They may, of course, address their challenges through finding channels of accepting that they remain childless. Others may seek to adopt or foster a child, while others seek assistance from professionals offering reproductive medical assistance. I hope that no matter what a couple choose to do, the choice is a thoroughly well informed one.

Infertility may give rise to unfavourable psychological, social and financial scenarios. The same can perhaps be said of the process of medically-assisted reproduction.

Against this backdrop the following questions arise: Are couples who choose the avenue of medically-assisted reproduction being adequately informed of how the process will affect their lives? Are couples sufficiently aware that they might have not one child but two or three? Are they realistically aware that multiple births imply a high morbidity and mortality risk?

Four sets of triplets and a set of twins (14 babies in all) were delivered at Mater Dei Hospital between December 21 and January 29. A number of them were premature babies of 30 weeks gestation or less and all weighing less than 1.5 kg.

All required intensive care of the highest order in the NPICU. Another set of triplets is expected to be delivered in the coming days. These facts, these numbers, in such a small span of time are perhaps strong indicators that the practice of IVF in the private health sector in Malta needs to be regulated. At the very least, these facts call for serious co-ordination with Mater Dei Hospital, whichis at the ‘receiving end’ of such reproductive processes.

There seems to be significant consensus that IVF and other medically-assisted reproductive methods need to be duly legislated and consequently regulated in our country. These practices are prevalent, they are here, being practised in our country, therefore let us instil some regulation accordingly – this is the line of reasoning that widely prevails.

In the light of events that we all witnessed in recent days, the establishment of embryo freezing as an accepted practice in Malta is a pathway which I know has gathered considerable support among healthcare professionals and the wider public.

I disagree. I strongly believe that we must look at all other options, away from embryo freezing and any other pathway which lends itself to the unnecessary manipulation of the presence of life, once it is established. Oocyte vitrification is one pathway which is encouragingly promising.

Oocyte freezing has leaped forward significantly over the past few years, through the development of the technique of vitrification which has, in turn, improved dramatically over the last couple of years. Experimental initiatives are now clearly yielding significantly positive, successful outcomes and results.

The clinical application of these advancements in such a technique is still in its infancy. Again, caution must prevail, but let’s not discard the potential of such alternative pathways.

The major challenge to the increased clinical application of the technique is the limited knowledge available pertaining to the possible damage, or otherwise, that oocyte vitrification may have on the development of the cell, embryo and foetus.

We all appreciate that even with embryo freezing, these are early days and, as yet, mere indications are revealed in the limited research studies at hand, regarding its safety, or otherwise.

In view of all this I feel we need to look deeper into alternative techniques and processes as is oocyte vitrification. My ministry is closely following developments in the field of assisted reproduction.

We are also tapping into the experience and expertise of our counterparts in the EU to look into the technical, ethical and medical aspects of this area of practice.

My message at this point in time, therefore is, let’s explore, let’s study such alternative pathways. There might be yet other options that we do not want to overlook.

Effectively addressing the needs of couples seeking to have a child is high on our agenda. Embryo freezing is not. We need to find a comprehensive way of marrying these two realities.

What do we do in the meantime? First of all we need to move with the times and need to empower individuals. Well-informed decisions can only be made if we give our individuals a detailed, holistic picture of the effects and consequences of the decisions, the avenues they choose to adopt.

We cannot, and should not, leave anyone in the dark or simply give them one side of a story. We must all be responsible and engage in a committed well-informed discussion on all aspects of medically-assisted reproduction procedures, and secure truly informed consent for the practice of any such procedures.

Dr Cassar is the Minister for Health.