The long and winding journey of IVF | Simone Attard

A lot has been said by those in favour and those against, since the Deputy Prime Minister and Minister for Health presented the Bill for Amendments to the Embryo Protection Act in Parliament. In this article I will not be delving into the amendments to the Bill, whether they are good or bad, gone overboard or are too little, as this is not within my remit as Director of the Embryo Protection Authority.

Although many are arguing that Assisted Reproductive Technologies (ART) have only been introduced in Malta a few years ago since the Embryo Protection Act came into force in 2013, IVF, as it is commonly known, has been practised in Malta for nearly 30 years. Yes, you are reading well 30 years, wherein the services were only provided by the private sector.

In fact, the first baby born from an IVF procedure carried out in Malta is now in the late twenties – 27 years old. Way back then ART services were not regulated by a law and we all know that IVF was associated with twins and triplets. This was due to the fact that at the time there were no protocols or guidelines on the number of oocytes to be fertilised so all resulting embryos were transferred back to the woman.

The need for regulation had for long been felt and it was very clear that this needed to come into force, however, this took a very long and winding road here in Malta. Way back in 2004 the Social Affairs Committee within Parliament started discussing the way forward to regulation, and experts from all fields were called to give their advice on the various aspects that had to be focused upon. I was one of these experts that were called in, and since 2004 I was focusing on the importance of keeping the prospective parents in the whole picture, the need to not only offer the best medical practices but also being there and offering support and counselling throughout the whole process of IVF.

I know full well what this infertility journey entails. Our journey ended up successfully, but many others are still struggling out there, even on our little island: Malta

After so many sessions and sittings held in front of different Parliamentary Committees, and although as experts we had provided several reports by 2009, there still was no agreement on the way forward. It was thus only in October of 2009 that the highest organ of our democratic country came to the final decision that a special ‘Select Committee for Medically Assisted Procreation’ be established. This committee was composed of medical doctors from both sides of the House of Representatives and again as experts we were called to focus solely on the need for an IVF and embryo protection law in Malta.

A final recommendations report was presented to Parliament in 2010, however the Minister of Health responsible at the time, did not take up the recommendations of the Select Committee. If he had done so, today Malta would not have had to face the current heated debate, as some of the amendments being proposed today were included in the recommendations report of 2010.

Finally, after eight whole years, in December 2012, the much awaited Act was enacted in Parliament and it came into force with effect from 1st January 2013. 2013 is also the same year in which the Embryo Protection Authority was established. As the sole regulator of all assisted reproductive services, the Authority’s functions include seeing that all ART services in Malta, carried out in both the public and private sector, are being offered to the highest of standards, to prepare the necessary protocols, inspect the clinics as necessary and keep records of all procedures. Top of the list in my role as Director of the Authority is to advise the Authority Board when decisions of high importance and emergencies are to be taken to safeguard the protection of the embryo, the interests of the prospective parents and the children to be born from the procedures.

As a professional who has worked in the field of procreation for over 20 years and who has also, together with my husband, lived as a prospective parent through this long and winding road for 12 whole years, I know full well what this infertility journey entails. Our journey ended up successfully, but many others are still struggling out there, even on our little island: Malta.

One in six couples are facing infertility; the majority of them having indication of infertility in both members of the couple thus making it harder to achieve a pregnancy. The latest statistics published by the Authority for 2017 show that the current pregnancy rate is low – 20.33% from fresh oocytes cycles and only 12.33% where cryopreserved oocytes are used. The take-home baby rate for Malta in 2017 was just 17.77%.

With the current law which now has been practised for six years we have seen the heartache of the couples undergoing this never-ending story, some of them with a history of infertility of up to fourteen years and undergoing their seventh cycle, with all that this entails; being financial, emotional and other issues.

Simone Attard is Director of the Embryo Protection Authority. She is a Systemic Practitioner with Specialisation in Infertility and Disability, and has also studied Bioethics at the University of Oxford in UK