Assisted Reproductive Technologies: Social and Cultural Aspects after the Italian Law 40/2004

Abstract

In-vitro fertilization (IVF) and assisted reproductive techniques (ART) have become common practice to threath some forms of Infertility and they are, in many countries today, regulated by established legislation, regulations or by committee-set ethical standards. The rapid evolution and progress of these techniques have revealed certain social issues that have to be addressed. The traditional heterosexual couple, nowadays, is not considered by many as the only ‘IVF appropriate patient’ since deviations from this pattern (single mother, lesbians) have also gained access to these treatments all over the world. Genetic material donation, age limitation, selective embryo reduction, preimplantation genetic diagnosis, surrogacy and cloning are interpreted differently in the various countries, as their definition and application are influenced by social factors, religion and law. Italian parlament in 2004 has passed a law on assisted reproduction that makes it a crime to freeze or destroy human embryos or to use donated sperm and eggs. The new rules limit the number of oocytes that can be fertilised to three. They also state that all the embryos created must be transferred into the woman's womb. Additionally they restrict the use of assisted reproduction techniques to sterile heterosexual couples in a stable relationship and ban all forms of pre-implantation genetic testing. The first official data on the effects of the restrictive Italian law on assisted reproduction, approved in 2004, have been made public by health minister in 2007. According to minister's report to parliament, the law has resulted in a decrease in the success srate of the procedures and more multiple pregnancies and adverse outcomes. The reproductive scientific societies have consistently condemned as “deplorable” the controversial Italian legislation, which includes the banning of donor sperm, eggs, or surrogate mothers and restricts assisted fertilisation to stable heterosexual couples. In particular it has criticised the ban on embryo freezing and the ruling that doctors can create up to three embryos during each attempt at insemination, but must transfer all to the woman's uterus at the same time, thus risking multiple births with all the consequent risk to mothers and babies. Financial and emotional stresses are also often described in infertile couples. Information as deduced from the world literature regarding IVF regulation, as well as about the existing religious, cultural and social behaviours towards these new technologies, should be considered in a correct ethical approach to the social aspects of assisted reproduction.