LONDON, NOV. 5, 2005 ( Restrictions governing in vitro fertilization have been eased in Britain. Announcing the changes on Thursday, the regulating Human Fertilization and Embryology Authority (HFEA) claimed the changes would mean a "better system for protecting the welfare of children."

The changes involve the norms related to the approval process for couples seeking to have children using IVF. The 1990 Human Fertilization and Embryology Act specifies that clinics have to make an assessment of the welfare of any child or existing children before they can provide treatment to a woman.

The HFEA has revised and in general narrowed down the guidelines that clinics should follow. After an introductory period, the guidelines will enter into force by January. Suzi Leather, chair of the HFEA, described the changes as being "fairer" for patients, reducing burdensome or intrusive elements.

Among the relaxations to the guidelines is the elimination of the need for a "commitment to raise children." The obligation to consider the age of the patients is also no longer a condition. Neither is the stability of the relationship between the couple seeking treatment to be taken into consideration.

Another condition cut out is the need to receive the approval of the family doctor prior to receiving IVF treatment. The task of evaluating the suitability of the patient is now delegated to the clinicians at the same fertility clinic.

Family groups have criticized some of the changes, the Scotsman newspaper reported Thursday. Norman Wells, director of the Family Education Trust, maintained the traditional family structure was an important factor for the child's welfare.

Two mothers

Even before the relaxation of the conditions for IVF treatment there was concern over some of the approvals granted. On Sept. 8 the BBC reported that scientists were granted permission to create a human embryo that will have genetic material from two mothers.

A team from Newcastle University will transfer genetic material created when an egg and sperm fuse into another woman's egg. The goal is to prevent mothers from passing certain genetic diseases on to their babies.

The experiment will not lead to a pregnancy, for the moment, because the resulting fertilized ova will be killed off at an early stage. Josephine Quintavalle, of the group Comment on Reproductive Ethics, criticized the approval given to the project by the HFEA. "This is playing around with early human life," she said.

And even when norms exist, they are not always followed. This was the conclusion of a study on whether clinics in Canada are fulfilling their obligations under federal legislation. An article published in the October issue of the Journal of Obstetrics and Gynaecology Canada found that only one of the clinics is fully complying with the laws governing the use of frozen human embryos in stem cell research.

The article, "Eligibility of Cryopreserved Human Embryos for Stem Cell Research in Canada," was written by Françoise Baylis and Natalie Ram. An abstract of the article published on the journal's Web site noted that 10 out of the 14 clinics that replied to their questionnaire allow the donation of cryopreserved embryos for research.

Only three of these 10 clinics, however, satisfy in writing the disclosure requirements for embryo research at the time of initial consent for the cryopreservation and future disposition of embryos. And only one clinic specifically identifies the option of embryonic stem cell research.

Worries were also raised in the Australian state of Queensland, where a doctor helped a woman become pregnant with a second set of quadruplets. According to a June 5 report in a Queensland newspaper, the Sunday Mail, Dr. Warren DeAmbrosis of the Queensland Fertility Group carried out the treatment on Dale Chalk.

Some of his colleagues expressed anger, saying that there was "enormous risk" to the babies' survival and health. But DeAmbrosis defended his actions. "This is very rare. It's not good medicine but this is an imprecise science," he told the Sunday Mail. "I could see three eggs, so either there was another one that I didn't see or one of them has split."

Chalk's first set of quadruplets, born after fertility treatment at the same clinic, were 9 months old at the time of the article. The second set of babies are due in December.

Defect risks

Other concerns arise over the risk that the IVF process poses to some of the children born. The Australian newspaper on Jan. 28 reported that babies conceived through IVF are up to 40% more likely to suffer birth defects, including cleft palate, spina bifida and heart problems.

The data came from the Telethon Institute for Child Health Research in Perth, Western Australia. The conclusion was based on an analysis of 25 studies from around the world.

The results did not indicate the cause of the problems. Researcher Michelle Hansen said the defects could be caused by the IVF procedure, or maybe couples who struggle to become pregnant could have an underlying medical condition that caused birth defects.

Among the possible causes related to the IVF treatment are the way the egg, sperm or embryo are manipulated, or the medications that are given to induce ovulation or to sustain pregnancy, noted Hansen.

The Australian findings were confirmed by U.S. researchers, the British newspaper Guardian reported Oct. 19. The findings were presented at a mid-October conference held by the American Society for Reproductive Medicine in Montreal. Jeffrey Nelson of the Huntingdon Reproductive Center in California used pre-implantation genetic diagnosis to screen 289 embryos created from healthy egg donors, all of whom were under 30. He found that 42% had damaged chromosomes.

Another study presented at the conference, done by a team led by Paulette Browne at the Shady Grove Center for Preimplantation Genetics in Maryland, used screening to examine embryos created from healthy donors aged 21 to 31. It found they had a 52% chance of genetic abnormality.

A third study, by Peter Nagy, a fertility expert at the Atlanta-based clinic Reproductive Biology Associates, found that young couples undergoing fertility treatment were more likely to have genetic defects than embryos created from healthy donors.

False expectations

Another paper presented at the Montreal conference warned that women are risking remaining childless due to false expectations about the success of having IVF treatment, the British newspaper Independent reported Oct. 20.

"There is an incredible amount of false and unreasonable expectation about fertility treatment and what it can do," commented Dr. Richard Kennedy, of the British Fertility Society.

He told the conference that doctors are partly to blame, because of the way in which IVF is talked about. The article noted that the average age of British women at the time of giving birth to their first child has risen from 22 in 1971 to almost 28 in 2002, and is continuing to go up.

Next Feb. 27 to March 1, the Pontifical Academy for Life will hold its 12th General Assembly, on the theme "The Human Embryo Before Implantation: Scientific Updates and Bioethical Considerations." Recent news items show the academy will have plenty to consider.