The House of Representatives this evening started to debate the Embryo Protection Bill - better known as the IVF Bill - with Health Minister Joseph Cassar stressed that the Bill's aim is to protect human life from its earliest stages.

Opposition spokesman Michael Farrugia said the Opposition backed the Bill and there were no differences with the government on its principles. However the Opposition disagreed with some provisions. In particular, prospective parents should not need to go before the new Authority to seek the go-ahead for IVF treatment as that was a confidential matter within the doctor-patient relationship. He also raised questions on the limitation of fertilisation to two eggs per cycle.

Dr Cassar in his introduction said the Bill was based on ensuring that the rights of embryos were recognised and respected; and that the responsibilities of institutions towards embryos were shouldered. 

Human life started from conception, or fertilisation of the woman's egg with the man's sperm. Life had to be protected from its earliest stages, and this was what this Bill aimed to achieved.

The Bill had been drafted in a scenario where assisted procreation was currently unregulated. Consultation had been broad and had taken years, but the government was satisfied that the Bill as drafted protected embryos while responding to the demands for assisted procreation.

The minister went on to explain how the Bill protected every cell which could develop into a human.

It banned abuses of the embryo including pre-implantation genetic diagnosis, sex selection, cloning or experimentation.

NO EMBRYO FREEZING

Embryo freezing as part of IVF was being disallowed since this essentially meant that the development of embryos - or human beings - was being frozen.

However the Bill allowed freezing of ova - the woman's eggs - a process known as oocyte vitrification which eliminated the need for embryo freezing. This new technology meant freezing before, not after fertilisation. Another advantage of this technology was that a woman did not need to go through various cycles of hyper stimulation. 

It was only in extreme emergencies, such as when a woman was seriously ill, that embryos could be frozen.

The Bill said that not more than two eggs could be fertilised at any one time and they had to be implanted immediately, without freezing.

Dr Cassar explained how the IVF process would be regulated by an Authority for Embryo Protection whose members will base their decisions on personal judgement without interference by other bodies.

The Authority would set high ethical standards on assisted procreation and ensure that they were observed. It would issue licences to clinics and carry out regular inspections.

The Authority would also decide on the adoption of  embryos frozen in exceptional circumstances. 

Dr Cassar said the government was continuing to hear arguments on the number of eggs which may be fertilised per cycle and implanted, with the aim of ensuring a healthy pregnancy while protecting the embryos.

A balance had to be struck between the chances of fertilisation, the risk of multiple pregnancies and other health concerns. The Bill was saying that not more than two eggs should be fertilised per cycle and the embryos should then all be implanted. However, in certain problematic or challenging cases, fertilisation of two eggs might not be enough. Even in natural processes, not all fertilised eggs yielded an embryo.

Therefore there were grounds for discussion on whether the Authority should prepare protocols to allow three eggs for fertilisation in some circumstances as indicated by doctors and determined by the Authority. This exception could also be granted to older women. The Bill, therefore could be amended for this purpose.

He stressed that in any case, all fertilised eggs had to be implanted.

The minister then went on to speak about the structure of the Bill in detail, including counselling, the informed consent of prospective parents and the status of offspring.

He pointed out that non-observance of the provisions of the law would be considered a crime, which carried heavy penalties, although there would be no imprisonment for the women-patients concerned.

OPPOSITION BACKS BILL BUT LISTS DISAGREEMENTS

Opposition spokesman Michael Farrugia said there was not much difference between the government and the opposition on the principles of the Bill. The Opposition would back the Bill but there were some differences which needed to be discussed and hopefully agreed upon by the time the debate ended.

The Opposition, he said, disagreed with the one-size fits all concept and the big brother attitude in sections of the Bill.

The need for this Bill was shown by the fact that 10% of couples, in Malta and abroad, had fertility problems but many could be helped through assisted procreation. Not every fertilised egg resulted in an embryo and then a baby, which was why he felt that a section of the Bill should be amended.

In the natural process, 80% of fertilised eggs did not implant themselves. In view of the limitations which this Bill laid down, at the committee stage, therefore, he would move amendments to give a bigger opportunity of success to the couples who sought IVF.

Dr Farrugia observed that the Bill laid down the minimum age limit of couples who could be eligible for assisted procreation - at 18 years -, but set no maximum age limit.

LICENCE TO HAVE CHILDREN

The Labour MP questioned the provision of the Bill where prospective parents needed to go before the Authority to seek the go-ahead for IVF. This, he said, was akin to seeking a licence to seek children, and it was wrong. This was a matter which should be restricted to the confidential doctor-patient relationship. 

Furthermore, parents born of IVF should not be labelled as such in their files, as the Bill implied.

Dr Farrugia noted that if somebody intentionally tried to fertilise more than two eggs in a cycle, he would be committing a crime and become liable to a heavy fine or a jail term. This, he said, was the case he had mentioned of 'one size fits all'. Whoever wrote this part of the law did not know what he was writing about.

People who sought IVF needed help to procreate. Other treatments would have failed. Where the eggs and sperm were healthy, limiting fertilisation to two eggs might be sufficient but in several cases, this was not enough. There should therefore be different protocols for different circumstances. As written, this bill undermined the professionalism of the medical profession, Dr Farrugia said.