Last week's European Society of Human Reproduction and Embryology (ESHRE) conference in Madrid provoked a rash of horror stories in the British media. One story in particular - research on eggs from aborted fetuses - left many commentators calling for more and tighter regulation.
This is a common response to new developments in assisted reproduction. The assumption is that regulation will prevent unsafe or unethical practices and protect patients - and it often does, depending upon your view of what is an unethical practice. But regulation does not always stop worrying things happening in assisted reproduction and it certainly doesn't always safeguard the health and wellbeing of patients. There was a strong message coming from the same ESHRE conference in Madrid that restrictive legislation and heavy-handed regulation can often do more to put patients and their babies at risk and to force them into situations not of their own choosing, than it does to protect them.
For instance, Professor Ricardo Felberbaum, chairman on the German IVF registry, demonstrated how restrictive legislation in Germany is harming patients. The Embryo Protection Act of 1990 states that no more than three eggs can be collected from a patient for fertilisation in vitro. After that, all embryos created must be transferred to the patient in order to avoid any embryo freezing or destruction. According to Professor Felberbaum, the imperative of putting back all available embryos, rather than a smaller number of good quality embryos selected from a larger batch, is resulting in lower conception rates for German IVF patients overall and yet higher multiple birth rates when pregnancies do occur. 'At present, Germany's laws reduce women's chances of becoming pregnant, but they do not prevent multiple pregnancies and all the risks associated with them,' said Professor Felberbaum.
Meanwhile, in Spain, it is legal to put embryos in frozen storage, but it is illegal to destroy embryos or to donate them to research, despite the fact that 74 per cent of Spanish patients with spare embryos in storage would like to donate them to research. Because most couples would prefer not to donate their embryos to other patients, there are currently 50,000 embryos sitting unused in frozen storage in Spain - some beyond the five-year storage limit.
In Denmark, IVF patients are only allowed to store their surplus embryos for two years, after which time many are left wanting more treatment, but being obliged to start a fresh cycle of IVF (with all drugs and medical procedures it entails) because they have run out of the time available to use their existing frozen embryos. Meanwhile, in Italy, it is likely that new legislation in the autumn will outlaw embryo freezing, embryo research and embryo screening. This will present IVF patients with similar restrictions - and the attendant risks to their health - to those experienced by patients in Germany, Spain, Denmark and other countries with restrictive laws on the creation of embryos.
Each country should, of course, have the freedom to make its own laws in this area. But legislators everywhere should understand that their tight regulation can have damaging consequences for patients. It is unforgivable that in an attempt to protect human embryos from destruction, the health of already existing adult patients and their babies is being put at risk.
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