Intended for healthcare professionals


Woman forced to have three embryos implanted is allowed fetal reduction to save her life

BMJ 2004; 329 doi: (Published 08 July 2004) Cite this as: BMJ 2004;329:71
  1. Sophie Arie
  1. Rome

    Italians are debating the “medieval” nature of a new law on fertility treatment after a young woman had to have three in vitro fertilised embryos implanted in her womb at once and then abort one of them because of health risks.

    The 26 year old Sicilian woman, who is very short, had a four minute operation at the Ospedale Microtemico in Cagliari, Sardinia, after a court there ruled that if the 11 week triple pregnancy continued, the mother's life would be at risk. Before the court ruling the woman had planned to travel to a London clinic and pay €1000 (£673; $1232) for a private operation.

    The fetus reduction ruling is the second reported since a law came into effect in March to put an end to Italy's reputation as the “Wild West” of infertility treatment. In June a court ruled that a Sardinian woman carrying twins should have one removed as it had the genetic disorder thalassaemia, common in Sardinia.

    For over two decades Italy had no legislation on infertility treatment because of a paralysing debate over the rights of the embryo in this predominantly Catholic country. Elderly women, including a 63 year old, had used the legal vacuum to travel to Italy and be helped to conceive.

    Now, under the new law, only stable, heterosexual couples of child bearing age can seek infertility treatment. If they do, they can create only three embryos in one cycle of treatment and all three must be implanted at once. Cloning, sperm donation, and surrogate motherhood are banned, and embryos cannot be tested before implantation or freezing.

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    Stefania Prestigiacomo, Italy's minister for equal opportunities: “Maybe it was better to pass a bad law… than never face the problem”


    Abortion, however, is legal in Italy up to 90 days into the pregnancy and later if there are health risks.

    The Medically Assisted Reproduction Law—which aims to give the embryo and the mother equal rights—is seen as a victory for the Catholic Church, which draws loyal support across the Italian political spectrum. It is currently being reviewed by a parliamentary committee after it was slammed by leaders in reproductive medicine in Italy and Europe and women's rights groups.

    “These cases show what is wrong with this law. It was created to protect the embryo, but what it does is force the woman to choose abortion,” said Dr Giovanni Monni, who did both operations and is a board member of the European Association of Perinatal Medicine.

    Stefania Prestigiacomo, minister for equal opportunities and a loyal member of Prime Minister Silvio Berlusconi's Forza Italia party, said she was deeply concerned about the weak points of the law. But, she told the Corriere della Sera newspaper, after a 25 year legal vacuum “maybe it was better to pass a bad law that needs improving than never face the problem.”