3 February 2011

In Vitro Fertilization

1.

The report by the parliamentary select committee on IVF is disturbing, particularly the recommendation to permit the freezing of human embryos. It is a well known fact that more embryos are usually produced in most IVF cycles than can be safely transferred into the uterus. The inevitable question about the current practice in Malta must be asked - what is done with the extra embryos? Since they are not frozen, are they simply selected and discarded? While freezing is the lesser of two evils, it is nonetheless morally wrong. Is freezing a human embryo using liquid nitrogen the best possible parental care and protection that parents could afford to their offspring? Indeed the fragile embryo may not survive the entire process of cryopreservation. Moreover the practice in other countries has shown that countless embryos are simply left in storage facilities facing an uncertain future. I am afraid that when our parliamentary representatives legislate to regulate IVF they will inadvertently condone what is inherently unethical.

2.

IVF is a double-edged sword.

The implantation of more than two embryos results in the birth of triplets - this is what led to the present crisis on the only Neonatal Intensive Care Unit on the island. Multiple pregnancies often end up in premature delivery, and these tiny preterm infants are at increased risk of death and long term neurological problems such as cerebral palsy. Prospective parents ought to be informed and counseled about the grave risks before they submit to IVF treatment. Moreover it is the responsibility of the health authorities to forbid the implantation of more than two embryos. This must be done NOW - the present crisis must never ever happen again!

On the other hand, embryos freezing is not without its ethical problems. Freezing and storing human embryos is definitely not the best possible care and protection that parents ought to afford to their offspring.

There are no easy answers to this dilemma, but we cannot go any other way that does not respect the sanctity of the human life from the moment of conception.

3.

As a paediatrician I have serious concerns about the practice of fertility treatment in Malta. Apparently the transfer of three embryos during IVF is still common practice, which results in the birth of triplets, as has happened in the past weeks.

Multiple births is the single greatest health risk associated with fertility treatment. The risk of preterm delivery and low birth weight is 50% in twins, and as much as 90% in triplets.

The risk of death before birth or in the first week of life is four times in twins when compared to a singleton, and sevenfold in triplets. Moreover he risk of developing long-term neurological problems like cerebral palsy is five times in twins, and 18 times in triplets.

For this reason the Human Fertilization and Embryology Authority of the United Kingdom has restricted the number of embryos that can be transferred in IVF to a maximum of two, with some exceptions. It is high time for the Maltese health authorities to enforce similar regulations in our country.

4.

Children are a gift from God; children are not a right or privilege to be fought for at all costs. “Behold, children are a heritage from the LORD, the fruit of the womb is a reward” (Psalm 127:3). Therefore you are justified to seek medical assistance only insofar as it is consistent with the Law of God and the teaching of the Scripture on the sanctity of human life from its beginning at conception.

IVF involves the women taking a fertility drug to help her produce more eggs and a hormone drug to prepare the womb for pregnancy. The eggs are then harvested and fertilised in the laboratory; the embryos are then placed inside the womb.

In the circumstances in which it is regularly practised, IVF involves the formation of more embryos than could be transferred into the womb. The extra embryos are either discarded or frozen. Also, IVF often results in twins or triplets. This is associated with a high risk of premature birth, neurological and developmental problems, and even death. For this reason, some clinics practice “selective reduction” - reducing the number of children the woman is carrying by aborting one or more of them.

Clearly, IVF cannot be morally justified when it involves the destruction of human life. Also, the freezing of embryos is contrary to the parental responsibility for their offspring and the respect due to human beings by exposing them to grave risks of death or physical harm and depriving them of maternal shelter and natural development. To my mind, IVF is acceptable only if one or two embryos are produced and implanted in the uterus.