The strange world of IVF regulation

This week's BioNews includes news that Italy is considering legislation to govern the practice of in vitro fertilisation (IVF) treatment. Given that IVF is now nearing its 21st birthday, Italy's legislative moves may seem somewhat belated. IVF services have been available in Italy for some years and Italian scientists have often been at the forefront of research into new techniques in the field. Only now, however, is the country preparing itself to regulate IVF and associated treatments. But is legislation always the best way of regulating IVF services?

Britain often regards itself as something of a trailblazer in this department. The UK Parliament spent many years consulting on and considering legislation before it passed the Human Fertilisation and Embryology Act in 1990. The Act is relatively permissive compared to subsequent legislation passed in France, Germany, Switzerland and Denmark.

As such, Britain stands alone in having legislation which is far-reaching but which leaves few practices completely outlawed. Canada looks set to adopt many of the features of the British legislation. But other countries, where access to treatment and to research opportunities remains open, have tended to steer clear of legislation. One such country is Italy, which has become renowned for treating a range of women (particularly those past the menopause) who have been refused access to services in other European countries.

The new Italian law will put an end to all of this. No IVF will be available to single women, lesbians or women who have passed the menopause. All IVF procedures must be carried out using the gametes of the couple concerned, thereby ruling out egg, sperm or embryo donation. In short, Italy will move from having a permissive IVF environment to having a restrictive one.

Having national rules about the provision of IVF services can have its advantages. Data, for example, can be collected and provided to prospective patients. But the system in the United States shows that such information can (at least in theory) be provided to patients without the need for a British-style statutory authority. Legislation isn't always the right answer, particularly for those people who wish to - but end up being denied - access IVF services. Sometimes, doing nothing is better than doing something.