Labour’s freeze on IVF puts its progressive credentials in reverse

Labour's freeze on its self-styled 'progressive' credentials have spelt a premature end to a law on in vitro fertilisation that matches the aspirations of childless couples by allowing for embryo freezing - the science that the Nationalist government seeks to ban through its Embryo Protection Bill.

It was with some surprise that, earlier this week, Joseph Muscat announced he would not support an IVF law that includes embryo freezing. Labour's war-room was more intent in lampooning Lawrence Gonzi over the phantom Brazilian construction giant that was expected to relocate to Malta.

But all that cacophonous samba served to downplay the great policy shift that had taken place inside Joseph Muscat's 'movement of progressive and moderates'.

First, the science

Childless couples understand the serious implications of Labour's great anti-climax on IVF. Here's why:

For the past 22 years, St James Hospital offered IVF in a completely unregulated environment. It did not freeze embryos, fearing it would be left with unclaimed embryos.

But the result was a series of questionable decisions - at least those that made the news - of three or more embryos being implanted inside women, with the risk of multiple pregnancies and the ensuing complications these can bring.

In an IVF cycle, women are over-stimulated with hormone drugs to produce anything between five to eight eggs, which are then harvested, and then fertilised with sperm.

Not all eggs will develop into good quality blastocysts (an embryo of five days), so it is with some luck that parents get to end up with one, two or even three embryos to implant.

With embryo freezing, a woman can have the first one or two embryos implanted while the rest can be frozen, allowing doctors to safely implant the number embryos without risking any multiple births. Parents could then return to the frozen embryo for another chance.

The Nationalist government is proposing a totally different route: egg freezing. This means harvesting the woman's ova, freezing all of them bar two. The two eggs will be fertilised, and if they develop into a blastocyst they get implanted. If it fails, women turn to the frozen eggs to restart the process.

The devil's in the science.

During its ban on embryo freezing between 2005 and 2007, Italy saw 505 deliveries of 582 babies from frozen egg transfers. But it was the reduced outcome of 8,000 stimulation cycles that produced 81,000 eggs: of those frozen eggs that were inseminated, 15,000 embryos were produced, but the pregnancy rate was 12.5% - significantly lower than that using fresh eggs (24.9%) or frozen embryos (16.4%).

Embryo freezing comes into play to safeguard women's health by limiting the transfer of fresh embryos to two; and offer women a back-up plan should the fresh cycle fail.

With egg freezing, there is only one fresh egg transfer (the first two only, since the rest will be frozen), and there is no guarantee that these develop into good blastocysts. Failing that, a frozen egg transfer will then depend on the survival of the egg after thawing, and again whether these will develop into good blastocysts fit for implantation once fertilised.

Secondly, the politics

Labour leader Joseph Muscat, the father of IVF twins, is intimate with the science of assisted reproduction. For the past years he has pledged an IVF law as the first act of legislation by a future Labour government, but surprisingly he is not attacking the science proposed by the conservative Nationalist law.

Instead Labour is seeking changes in medical practice: giving specialists the decision to determine how many eggs are fertilised and implanted (a necessary case-by-case policy that could improve success rates) and curtailing the powers of the Embryo Protection Agency to issue their green light for IVF parents, especially due to data protection issues.

Betraying the now faded progressive stamp, Muscat failed to reverse the allegedly 'pro-life' bias of the new 'embryo protection' law. Inside his party, a veteran and socially liberal MP like Evarist Bartolo had dubbed the bill "unworkable and humiliating" and that success rate of egg freezing was "next to nothing". But instead, Muscat announced that conservative and archaic Catholic MP Adrian Vassallo would be voting against the law but support Labour's amendments to the law.

But why did Muscat not send a statement that Labour was seeking a different law, one that safeguarded the choice for embryo freezing? Given the timing of the coming general elections, was this not a law that Muscat could lose out on in the House and use it as a battleground for a socially liberal issue that demarcated Labour from the conservative elements that the government find so hard to betray?

The answer, we now know, is the opposite. Perhaps, Muscat sensed that here was another bill that could not be used to ambush the weak Nationalist backbench; one law that happened to enjoy the support of independent MP Jeffrey Pullicino Orlando.

Instead of proposing the difference between the Nationalist government and a future Labour government, Muscat chooses to play along a neutral policy route that will not lose him votes. But it is hard to reconcile his vocal statements in favour of couples denied IVF treatment by being forced to seek treatment abroad, with a law that curtails their freedom to choose.

Couples can savour the irony instead: from an unregulated IVF industry to an over-regulated national treatment that only assuages the consciences of our lawmakers.