Assisted fertilization

Medically assisted procreation (MAP) and pre-implantation diagnosis: the main points of law n.40

Italian law deals in detail with medically assisted procreation techniques, in order to favor the solution of reproductive problems deriving from sterility or infertility.

The fundamental structure of the regulation is found in the law n. 40 of 2004 , even if the jurisprudence has intervened in the matter in a very incisive way.

 Currently, recourse to medically assisted procreation techniques is permitted only when the impossibility of removing the impediments to procreation in any other way has been ascertained . To access it, cases of sterility and infertility must be documented by a medical record.

Only adult couples of different sexes, who are married or cohabiting, and of potentially childbearing age, can access medically assisted procreation techniques. Both members of the couple must still be alive. Furthermore, heterologous fertilization is expressly prohibited , which takes place when the seed or the ovum comes from a subject outside the couple.

The law then sets very restrictive conditions for the protection of the unborn child : first of all, in fact, those born as a result of the application of medically assisted procreation techniques will have the status of legitimate children or recognized children of the couple who to techniques.

Secondly, unlike children born without the application of PMA techniques, the mother will not be able to declare the will not to be named and the father will not be able to exercise the action of disavowal of paternity .

In essence, once a choice is made, there is no going back.

Medically assisted procreation interventions are carried out in public and private structures that have been authorized by the regions and entered in a special register . The therapeutic options to which the couple can actually access are described in detail in the guidelines of the Ministry of Health , in which it is emphasized that the age of the woman must first of all be taken into account.

We now come to the very thorny problem of protecting the rights of the embryo born from ART, and how to reconcile it with that of protecting the health of the other subjects involved, especially the mother.

The law, in art. 13, establishes that any form of experimentation on embryos is prohibited . Clinical and experimental research is permitted only on condition that exclusively therapeutic and diagnostic purposes are pursued, aimed at protecting the health and development of the embryo itself, where alternative methodologies are not possible.

The cryopreservation and suppression of embryos is expressly prohibited (while the cryopreservation of both male and female gametes is possible, following written consent). The only exception is when the transfer into the uterus is not possible due to a serious and documented cause of force majeure relating to the woman’s state of health, a cause that cannot be foreseen at the time of fertilization. The transfer must still take place as soon as possible, but without prejudice to the health of the woman.

Originally, the law established that embryo production techniques should not create a number of embryos higher than that strictly necessary for a single and contemporary implantation, in any case not higher than three. The Constitutional Court intervened on this point , which abolished both the limit of three embryos and the need for a single implant. In essence, now each doctor will be able to independently decide the best solution on a case-by-case basis.

The art. 14, paragraph 4, prohibits the reduction of the embryo in multiple pregnancies.

Finally, the question of pre-implantation diagnosis. It was originally forbidden by the ministerial guidelines (adopted with DM 21.7.2004); following the intervention of the Lazio Regional Administrative Court first and then of the Constitutional Court, the ban was lifted, unless prohibited experiments are carried out or eugenic purposes are pursued.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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