A Bill on in-vitro fertilisation may have to include “technical clarifications” to address clinicians’ concerns over the success rate of fertilising only two eggs, according to Mater Dei Hospital’s director of obstetrics and gynaecology.
Prof. Mark Brincat yesterday said the Health Ministry was “actively talking” with clinicians, including top Italian expert Luca Gianaroli.
Dr Gianaroli, whose interview appeared in yesterday’s The Times, said the proposed law was restrictive because it limited fertilisation to two eggs and placed more emphasis on egg freezing rather than embryo freezing.
However, according to Prof. Brincat, since the interview, the ministry seemed to have understood some of the concerns raised by Dr Gianaroli and others.
Prof. Brincat said a clear distinction had to be made between fertilised eggs and embryos. “They are not the same since fertilised eggs may not develop into embryos.”
He said this “technical clarification” had to be made in the proposed law to give clinicians “some leeway” to have the best chance to achieve an optimum of two embryos. Such a clarification will have to take into account the couple’s medical history, he added.
“Embryologists are equipped today to determine how many eggs have to be fertilised to end up with a maximum of two embryos,” Prof. Brincat said, adding that embryo freezing would be used as a back-up option.
Justice Minister Chris Said, who is piloting the Bill, had said three weeks ago that three eggs instead of two may have to be fertilised in cases involving women above a certain age.
The Bill makes it clear that only two embryos can be transferred to the mother – to avoid problems associated with multiple pregnancies – but it also speaks against the intention to create more than two fertilised eggs.
It also disallows embryo freezing except in serious cases when embryos cannot be transferred to the woman because of some problem.
Dr Gianaroli had argued that limiting the number of eggs for fertilisation reduced the chances of pregnancy because a woman could end up with one, two or no embryos for transfer.
Prof. Brincat, who has been an IVF practitioner in the private sector for more than 20 years, said the Italian doctor’s concerns mirrored those of any clinician.
However, he preferred the debate to concentrate on improving the fresh egg cycle. In Malta embryo and egg freezing were never practised and by using only fresh eggs a 40 per cent success rate was achieved, he added.
Prof. Brincat said his department had to work within the law. “If the chosen route was that of oocyte vitrification (egg freezing), we are determined to become a centre of excellence in the field while acknowledging that embryo freezing had to be available as a back-up.”
Meanwhile, in a statement reacting to Dr Gianaroli’s comments, the Health Ministry confirmed it was engaged in “active discussions” with interested parties, including the Italian expert.
The ministry said Dr Gianaroli had advised it on the establishment of IVF services at Mater Dei and a number of meetings took place in the latter half of 2011 between the health authorities and his clinic Sismer.
“The cornerstone of the consultations and all arising discussions was clearly that the IVF services at Mater Dei Hospital were to be based on the practice of oocyte vitrification,” it said.
A report, which outlined the training and equipment needs at the public hospital, was also presented to Health Minister Joe Cassar by Dr Gianaroli in October last year.
The ministry insisted that the consultation process was ongoing and a meeting was scheduled with Dr Gianaroli in early September.
ksansone@timesofmalta.com