Issue link: https://maltatoday.uberflip.com/i/969423
16 HOW THE LAW WILL CHANGE Eligibility for IVF Current law: IVF can only be provided to adult heterosexual couples who are either married or in a stable relationship. Lesbi- ans are excluded despite the introduction of same-sex marriage last year and civil un- ions three years earlier. Single women are also excluded. The new law: The definition of prospec- tive parent will change to cover any adult person, irrespective of gender or sexual ori- entation. This will make IVF available to all women, including singles and lesbians. The inclusion of surrogacy may also open up the possibility for the whole spectrum of the LGBTI community to have a baby. Egg fertilisation Current law: The law prohibits the fertili- sation of more than two eggs. It does allow an exception for three eggs to be fertilised, if this is medically necessary in some cases and doctors would first have to seek the authority's consent. Statistics show that in 40% of cases doctors have asked for permis- sion to fertilise three eggs. All embryos pro- duced have to be transferred to the womb. The new law: Doctors will be able to fer- tilise up to three eggs in the first cycle and five eggs in any subsequent cycle. However, if the prospective parents do not consent to embryo freezing and the subsequent adop- tion of any unclaimed embryos, doctors will only be able to fertilise up to two eggs in all cycles of the treatment. In all instances, the maximum number of fertilised eggs that can be transferred to the womb in any one cycle will be two. Any extra embryos will have to be frozen. Embryo freezing Current law: It is illegal to freeze embryos as part of the IVF treatment. The only exception is in cases - referred to in the law as force majeure - where implantation of embryos cannot take place because of something that happened to the woman. So far, there has only been one case where this has happened and two embryos had to be frozen because the mother fell ill before the implantation process. The new law: Embryo freezing will be allowed subject to an agreement between the prospective parent or parents and the authority. The authority can issue a five- year permit to the prospective parents al- lowing them to freeze extra embryos if they agree to give up any unclaimed embryos for adoption. Given that the new law allows the fertilisation of a maximum of five eggs, of which only two can be implanted in the womb, embryo freezing becomes an inte- gral part of the IVF process. Adopted embryos Current law: Although the authority can put up frozen embryos for adoption the law does not give a detailed outline of how this should be done. There is a one-year time frame from when the embryo is frozen by which the authority can proceed with adop- tion but makes it incumbent on the author- ity to consult with the prospective parents before proceeding with the process. The new law: The authority can give up unclaimed frozen embryos for adoption, in a process that is better defined. The author- ity can proceed with adoption if the parents of the embryo decide not to renew the five- year certificate granted them to freeze em- bryos, or if the prospective mother reaches 43 years of age. The law makes it clear that the person adopting frozen embryos cannot have embryos originating from different couples, implanted into the womb at the same time. Once the adoption takes place, the original parents lose all rights on the embryo and are exempt from any obliga- tion towards it. Sperm and egg donations Current law: Sperm and egg donations are illegal. Only gametes from the pro- spective parents can be used to produce embryos that will then be implanted in the same woman from which the eggs were har- vested. The new law: Sperm and egg donations will become legal. Prospective parents can identify the donors or donor, in which case, the identity of the person will be known to them. The donor or donors cannot be next of kin. However, prospective parents can also benefit from gamete donations by using sperm and oocyte banks. In this case, the donor will remain anonymous. The law will make it incumbent on the au- thority to hold a register with medical and other information on the anonymous do- nors. This information will be made avail- able to the child born from the donated gametes upon reaching 16, or to the parents if required. All donors, whether known or anony- mous, have to be 18 and older, but women who donate eggs cannot be older than 36. Donors can only make one donation, and the gametes can only be used in one pro- spective parent. Sperm and oocyte banks Current law: The principle legislation makes no provisions for sperm and egg banks but regulations drawn up by the au- thority do allow the freezing of unfertilised eggs that are harvested from the woman who will make use of them. There have been IVF processes at Mater Dei that used frozen oocytes. The new law: The law proper makes pro- visions for the creation of regulated sperm and egg banks, where gametes can be fro- zen for future use. Sperm can be preserved throughout the lifetime of the person from which it originates, while oocytes will have to come from women with a maximum age of 36. Eggs cannot continue to be preserved after the death of the woman from whom they originate. However, the law will allow the use of sperm and eggs of people who die but would have previously made a direct donation of their gametes. Surrogacy Current law: Surrogacy of all types is il- legal and the doctor performing the IVF or embryo transfer can be punished by a fine ranging between €5,000 and €15,000 and a maximum three-year prison sentence. The surrogate mother's punishment is de- creased by one or two degrees. The new law: Surrogacy against payment will remain illegal and punishable as it is today. But altruistic surrogacy may be al- lowed. However, the introduction of altru- istic surrogacy is not automatic because it depends on the minister making rules on how it can be practised. Health Minister Chris Fearne has said this part of the law will be subject to a public consultation ex- ercise. The introduction of altruistic sur- rogacy could mean that women unable to carry a child in their womb, will still be able to have a child but it also means that the whole spectrum of the LGBTI com- munity could use surrogacy as an option to become parents. However, the manner by which surrogacy can be practised will depend on the type of regulations to be in- troduced, if at all. Embryo research Current law: Preimplantation genetic diagnosis (PGD) and research using em- bryos are both illegal. The new law: PGD and research using embryos will remain illegal. maltatoday SUNDAY 15 APRIL 2018 News An idiot's guide to how the IVF law will change The Embryo Protection Act is in for a radical overhaul that will make in-vitro fertilisation accessible to more than just different-sex couples. The changes are also aimed at increasing the chances of infertile couples to conceive a child. But the proposals put forward by the government also tread ethically contentious territory. Kurt Sansone gives a simple guide to the salient changes being proposed and the ethical arguments that may follow.