New law forces Italian couple with genetic disease to implant all their IVF embryos

BMJ 2004; 328 doi: (Published 03 June 2004) Cite this as: BMJ 2004;328:1334
  1. Fabio Turone
  1. Rome

    An Italian judge ordered a sterile couple to transfer all the embryos obtained with assisted reproduction techniques, despite the fact that both would-be parents carry the recessive gene for β thalassaemia, wanted a preimplant diagnosis, and would not keep a child born with the condition.

    The law, approved early this year (BMJ 2004;328: 9), bans both freezing and destroying embryos, limits to three the number of oocytes that can be fertilised, and states that all the created embryos must be transferred. It also restricts the use of assisted reproduction techniques to sterile couples.

    But the law does not affect the legislation allowing abortion in the first six months of pregnancy in the case of serious illnesses.

    The couple, from Lecce in southeast Italy, had tried several attempts in a private centre in Catania, Sicily.

    “When the law came into effect, I told them I would be obliged to transfer all embryos,” explained the couple's doctor, Nino Guglielmino, medical director of the Hera Centre, which is run by a non-profit making association of parents of children born via in vitro fertilisation.

    “The woman couldn't stand the idea of starting a pregnancy with a β thalassaemic embryo, which she would abort, so we agreed to appeal this part of the law in a court.”

    The judge from the Court of Catania had stated that, according to the new law, the woman did not have the right to choose to have a healthy baby.

    Embedded Image

    Embryo at 10 cell stage, on the point of a pin


    Speaking in a radio interview, the 35 year old woman, who teaches disabled children and who was given a false name, “Laura,” to maintain privacy, said: “Less than one month after the court's decision and the embryo transfer, I was hospitalised for a gastric haemorrhage, likely to have been caused by stress, and the pregnancy ended.”

    The tests later showed that the embryo was healthy.

    The health minister, Girolamo Sirchia, insisted that the guidelines being drafted by a commission will correct this part of the new law, but other effects of the law are also starting to emerge.

    Many hundreds of non-sterile couples, fearful of having babies with genetic illnesses, have started to go abroad. Many specialists and researchers in the field have done the same.

    In addition, the experience of the first few months with the new rules seems to confirm the worst scenarios anticipated by the opponents of the law. Many centres report a reduction in the success rates for women older than 35 and a steep increase in multiple pregnancies in those younger than 35, who are often implanted with three embryos.

    • Professor Carlo Flamigni, a pioneer in assisted reproduction techniques, has announced his intention to admit to the authorities in Bologna that he froze an ootid (the oocyte after the penetration by sperm but before the formation of a zygote). Italian law bans only the freezing of embryos. “Maybe I'll be arrested,” he said, “but maybe the judge will decide that, according to the law, the ootid and even the zygote can be frozen, since neither was cited in the law.”