Embryo vitrification ‘necessary’ due to low birth-rate from IVF

The live-birth rate of Malta’s current system of assisted reproduction – oocyte vitrification – stands at just 8% of the 51 IVF cycles completed on the national health service between January 2014 and January 2015.

The low rate of births from the system of freezing the ova, as opposed to embryo freezing, is one of the factors informing the government’s legislative drive to widen access to assisted reproductive technology.

“The rate of completed pregnancies is too small and we cannot leave it like this, especially with the availability of technology that can assist us,” parliamentary secretary for health Chris Fearne said.

In 2013, the government introduced in vitro fertilisation services on the NHS, setting strict limits on the fertilisation of eggs to two for each cycle. The law banned embryo freezing and sperm donation.

The Labour government wants to review the law, to allow ART patients to also have access to embryo ‘vitrification’.

In the 30 months since its introduction, there have been 411 IVF and intra-cytoplasmic sperm injection (ICSI) cycles up to June 2015: 116 resulted in viable pregnancies.

Despite the clinical pregnancy rate standing at 30%, Fearne says that the live birth rates have not been satisfactory.

His inter-ministerial committee is looking into the introduction of embryo ‘vitrification’, which in contrast to the technology of slow freezing, is said to be a more efficient method for the cryopreservation of embryos.

Fearne told MaltaToday that vitrification provides a higher survival rate, and minimal deleterious effects on embryos when they are thawed, improving clinical outcomes. “Nine out of 10 embryos can survive the process in vitrification,” the health secretary said.

Additionally, there will be limits on the number of eggs that can be fertilised and implanted.

But ethical issues over the fate of additional embryos that could be left ‘unwanted’ by parents is garnering an opposition to the government’s amendment of the IVF law.

Pro-life groups under the Malta Life Network were joined by former prime minister Lawrence Gonzi last Friday, who legislated the original Embryo Protection Act.

During the debate on Friday, they warned they would collect the signatures necessary to request an abrogative referendum if the law is approved by MPs.

Former PN leader Lawrence Gonzi was unequivocal in his belief that freezing embryos was “equivalent to the destruction of life”.

“If such a law passes, it will represent a conscious decision to end human life and will sow the seeds for abortion,” Gonzi said. “The IVF law was passed in Parliament unanimously after months of analysis and debate, and it is unheard of for somebody to suddenly come up with an idea that will discard it all.”

Fearne has however taken issue with claims that embryo vitrification was akin to abortion.

“Someone wrote that we are going ‘to flush down embryos’, which is absolutely not the case. Embryo vitrification will be for parents who can’t give birth to a child with the existing process,” he said.

He added that, at most, “only two embryos would be vitrified, and in exceptional cases.”

The chances of having a baby from the first cycle is of 30%, he added. “We are giving the possibility of life where there is none, with the assistance of technology,” Fearne said.

The couple would then have two options: return to a second pregnancy or give the embryo up for adoption. The Embryo Protection Authority would then handle the adoption of the embryo.

The government will also make it legal for gay women to become parents through either sperm donation, or to have access to IVF. “All women should have access to IVF, irrespective of their sexual orientation. Why should there be discrimination on something medical?” Fearne said.

The government will be drawing a line at surrogacy. “I don’t think surrogacy should not be considered at this stage.”

He also said the law will not be considering the introduction of pre-implantation genetic diagnosis (PGD), a procedure that allows the identification of genetic defects within embryos created through IVF.

Fearne said he expected the input from the bioethics committee will be important towards the formulation of the law, which will have to devise a system that allows embryos to be put up for adoption.

But the consultative committee is chaired by Labour MP Deborah Schembri, who in an interview with Sunday newspaper Illum admitted that she was against embryo freezing.

Fearne however expressed confidence that the committee would operate professionally, without basing its decision on personal opinions.

The bioethics committee is currently analysing a report prepared by the inter-ministerial committee, which reviewed 20 submissions submitted during the consultation period.

The inter-ministerial committee – which includes representatives of the health, justice and civil liberties ministries – is analysing sentences delivered by courts in Europe and the European Court of Human Rights on IVF. “The European case law will affect what legislation is enacted in Malta. This report will be presented to the Cabinet, following which a bill will be presented to parliament,” Fearne said.

The presentation of the report is expected in December.