The number of babies born in a single year through assisted reproduction therapy in Malta’s fertility clinics reached a record high of 125 in 2023.

But while the Embryo Protection Authority hailed the “new milestone” since it started registering data, there was a downside in its annual report.

Twelve embryos sit in a frozen state of legal limbo after the in vitro fertilisation patients who once sought to become parents gave them up for adoption.

The issue is a byproduct of Malta’s laws that do not allow unclaimed embryos to be destroyed but which also do not cater for the adoption of unborn babies.

It was a problem that was first flagged a year ago when four embryos that were cryopreserved (frozen at very low temperatures to be preserved) by a couple in 2019 were put up for adoption.

However, the matter remained unresolved and another three couples split up last year and will not be implanting the frozen embryos, increasing the total number of abandoned embryos to 12.

The total of frozen embryos as at the end of 2023 stood at 612 but the remaining prospective parents have expressed their willingness to make use of them and have until their late 40s to decide what to do with them.

Changes to the law regulating IVF in 2018 allowed for embryo freezing on condition that prospective parents agree to give up unclaimed embryos for adoption. Once prospective parents declare they will no longer use the embryos, custodianship goes to the authority.

The Adoption Administration Board has the legal power to make recommendations to the Embryo Protection Authority regarding the eligibility and suitability of prospective parents to adopt an embryo.

But there is a gap because Malta’s adoption agencies are not licensed to deal with embryos. This means the embryos cannot be passed on to them to process the adoption.

“Meetings are still under way, with the State Advocate Office and the Social Care Standards Authority… Meanwhile these embryos will remain cryopreserved at the MDH ART Clinic until the necessary changes to legislation come into place,” the report, tabled in parliament, said.

These embryos will remain cryopreserved at the MDH ART Clinic until the necessary changes to legislation come into place

The authority is the regulator of all assisted reproductive therapy that takes place at the State’s Mater Dei Hospital and in private clinics – mainly the Hope Fertility and IVF facility and St James Conception Unit.

In the 10 years since records began, there have been 601 babies carried out through fertility procedures. Of those babies, 154 were born from a frozen embryo transfer.

However, while the number of babies born through fertility treatment reached a record high last year, the success rate for IVF remained on par with previous years. The percentage of live births stood at 26.88%, a marginal increase of 0.24% over 2022.

The report showed that, in 2023, 601 procedures were performed – 404 at Mater Dei and 197 at Hope Fertility and IVF. Procedures include collection of sperm and oocytes and implantation.

14-year-old is youngest patient

In Malta, women aged between 18 and 48 are eligible to undergo assisted reproduction therapy. During 2023, the youngest to undergo treatment was a 14-year-old girl, who underwent fertility preservation at the Mater Dei clinic.

While the report did not give any details, this procedure is usually carried out on girls and young women who risk the chance of motherhood as a result of treatment for cancer, blood or immune disorders.

The oldest patient was 46 and underwent an embryo transfer cycle at the private facility Hope Fertility and IVF.

In 2023, 363 people applied for the approval of refunds of medications used in medical assisted procreation for patients undergoing treatment on the NHS. This was introduced in 2022.

To date, the authority has approved a total 634 refund applications.

As of January 2022, the government refunded a total of €1,028,53 to prospective parents.

The report also mentioned regular complaints about waiting lists at the Mater Dei clinic.

The government recently announced that around 650 couples on the waiting list will be able to receive treatment at a private clinic, thanks to a €6 million investment.