Pushing the Limits on In Vitro Fertilization

ROME, JAN. 22, 2005 (Zenit.org).- Italy's Constitutional Court has opened the way for a series of referendums that could substantially weaken the law governing in vitro fertilization clinics. After years of debate, Parliament last February approved a series of norms on IVF treatment. Previously there were no legislative limits on the controversial procedure.

While the legal norms did not satisfy all the requirements of the Catholic Church, Italian bishops nevertheless declared their satisfaction for the measures that substantially improved matters. Fierce opposition to restrictions on IVF, however, did not abate with the parliamentary vote. In Italy the Constitution permits a law, or part of it, to be abrogated by means of a referendum, once enough signatures have been collected.

Following a campaign that was successful in obtaining these signatures, the Constitutional Court on Jan. 13 approved a vote on four of the five measures sought. Among the parts of the law sought to be canceled are the limitations on freezing and subsequent experiments with embryos. If this is abolished, embryos could be used to produce stem cells.

The referendums also seek to eliminate the limit on the number of embryos that can implanted in the womb and the prohibition on use of pre-implantation diagnosis that discards embryos with possible problems.

Current law prohibits the donation of sperm from someone outside the couple undergoing IVF treatment, and contains a recognition that the rights of the embryo need to be taken into account. All of these provisions would be abolished if the referendums are approved.

Chance to educate

This prospect alarms Francesco D'Agostino, president of Italy's National Bioethics Commission. In an interview Jan. 15 in the newspaper Corriere della Sera, he declared that it was necessary to maintain the current provisions that provide some respect for human life, and not to allow embryos to be manipulated according to merely utilitarian criteria.

D'Agostino also noted the contradiction in seeking to lift restrictions on research with human embryos, at a time when pressure to outlaw experiments using animals is rising.

Italian bishops, gathered as a conference this week, declared their opposition to any weakening of the law regulating IVF clinics. The conference president, Cardinal Camillo Ruini, said that he hoped the debate over the referendum questions would be an opportunity to educate Italians about the values at risk, the daily La Stampa reported Tuesday.

The bishops' current strategy is to convince Catholics not to vote, since referendums with less than a 50% participation rate are invalid.

"All over the place"

Relevant to the Italian debate might be the experience of other countries where there are few norms governing IVF clinics. A report last Tuesday by the Associated Press, for instance, contains revealing information about what goes on in U.S. facilities.

According to a survey of clinics published in Fertility and Sterility, a journal of the American Society for Reproductive Medicine, most clinics in the United States would help women over age 40 to become pregnant. Only one in five would refuse single women, and one in four would help a woman suffering from the AIDS virus. The information came from the 210 clinics or doctors' offices that answered the survey questions.

"They were all over the place with respect to their views and values," said University of Pennsylvania bioethics chairman Arthur Caplan, who worked on the survey. Reproductive decisions now "are too driven by the desires of couples and not enough by the interests of children," he said.

Another revealing result was that while 80% of the clinics ask potential customers to meet with financial coordinators, only 18% had them see a social worker or psychologist.

Late moms

Unregulated IVF clinics captured media attention this week with news of the birth of a baby, Eliza Maria, to a 66-year-old retired university professor from Romania. Adriana Iliescu is believed to be the oldest mother to give birth, the London-based Times reported Monday. Her daughter is one of three embryos she had implanted; the other two died. The embryos were produced with the help of donated sperm -- Iliescu is unmarried. The surviving child was delivered by Caesarean section in the 33rd week of pregnancy.

"I believed all my life that a woman has a right to give birth and that is why I had to follow my dream, no matter how old I was," Iliescu was quoted saying.

In a commentary published the same day by the Times, Cristina Odone noted that "the ethos of the IVF industry -- and this includes all other forms of assisted reproduction -- remains questionable." She argued: "Children are neither a right nor a commodity, and the IVF industry treats them as both."

Writing under the pseudonym "Coco Gillespie," a British woman published an article in the Guardian newspaper last Wednesday, reflecting on her experience as a daughter born over 30 years ago, as a result of a medical fluke, when her mother was 50.

"The offspring of elderly parents are always stalked by the specter of death, and this will be even truer for Eliza than it was for me," the writer commented. "For years as a child, I was plagued by recurring dreams about my parents dying, or of how I would manage to care for them if they became incapacitated." She also lamented having had no siblings, or even cousins, her own age.

Schoolgirls' choice

At the other end of the scale in Britain, girls as young as 14 are asking for financial help from the National Health Service to have IVF treatment, the Telegraph reported July 4. The newspaper said that one clinic had been approached by four girls aged 14 who wanted to use IVF, as they had been unable to conceive through conventional means.

In Israel, meanwhile, women are undergoing up to 35 IVF treatments in an effort to bear children, the London-based Times reported July 19. According to the article, married and single women in Israel are allowed virtually unlimited attempts up to age 45. From ages 45 to 51, women are allowed to continue treatments with donated ova.

Israel currently provides 3,400 IVF treatments per 1 million people, compared with 300 in England. The result is that nearly 5% of babies born in Israel are test-tube babies.

The multiple fertility treatments, according to the Times, "cause enormous emotional, mental and physical strain, which is often left unaddressed by the doctors who treat their patients."

Another much-debated practice is posthumous IVF. The Independent newspaper reported Oct. 4 on Diane Scott, 44, who gave birth to a daughter 30 months after the death of her husband. Her husband, Peter, suffered from cancer, but before he underwent chemotherapy he stored sperm, which was later used by his widow.

Diane Scott is one of 30 British mothers who have given birth using sperm from dead partners, according to the Independent. Whether this kind of news influences Italian voters when they decide on IVF referendums, remains to be seen.