Risks of IVF

I feel it correct to express a word of caution in the context of in vitro fertilisation (IVF). It has been reported that the Children's Commissioner, Sonia Camilleri, expressed the view that IVF should be banned in Malta and for the Ministry for Family and Social Solidarity, Dolores Cristina, a contrary advice.

In September 2003, Lord Winston, then of Imperial College, London, reportedly expressed some concern about the long-term health of babies conceived through some test-tube techniques. He specified that he did not consider IVF itself as dangerous but expressed concern about certain techniques, such as single sperm injection into an egg and frozen embryos.

He also expressed the concern that we are surprisingly ignorant of the risk of chromosomal abnormalities on ova induced by the drugs given to stimulate ovaries.

Maria Tachataki was reported as having identified an abnormality in a tumour-suppressor gene in frozen embryos. Intracytoplasmic sperm injection was also reported to be associated with 9.5% abnormal changes in the genome.

IVF babies have been reported as being more than twice as likely to have abnormal birth weights and under certain circumstances to possibly be more prone to develop vascular disease, hypertension and possibly osteoporosis and diabetes by the age of 60. The fact is that we do not know.

Certainly, last October the UK government fertility watchdog was reported as wanting to monitor the long-term health effects of IVF treatment, this more than 25 years after it had been introduced. I do not believe in scare tactics but I believe in caution.

When BSE was first reported I stopped eating beef and advised my relatives to do the same. Despite the different advice given, I persist in my choice and time has proved me right. We used to be told to have babies sleep face down, only for it to be recanted later with advice to have them sleep face up. I advised my relatives not to take HRT and recently we have had the association of HRT and breast cancer proven.

I therefore advise caution, because we do not know for certain what the long-term effects on babies born this way are going to be, because we do not know if we will be breeding a generation of subfertile citizens and because there is a great deal of heartbreak and cost with the many failed IVF treatments after hopes have been fanned. Certainly, in my opinion, this is not a route the national health service should take.

I am, however, averse to banning individual choice but this should be fully informed. The treatment should be carefully monitored and regulated. I let readers decide how good we are in general, and not specifically in medicine, at ensuring that.

The government must ensure that regular, independently verified statistics of the rate of success of treatments, of morbidity and of costs, are published so that choice can be better informed. We must also clarify how many ova are going to be harvested and fertilised, how many will be implanted, if there will be any freezing of ova, whether fertilised or not, and what is going to happen to any redundant ones.

I comment as a layman and with great humility, as it is now many years since I retired from medical practice and any way, this was not my speciality. However, acumen advises caution and not to resist marketing pressures, particularly on the emotionally vulnerable.