Issue link: https://maltatoday.uberflip.com/i/981272
| SUNDAY • 13 MAY 2018 maltatoday 17 NEWS aged 35 or younger, you need eight eggs to get one good em- bryo. In women aged 36 and older, you need 25 eggs. So basi- cally it's lottery. That's why the success rate with frozen oocytes is dismal... Meanwhile, the discussion has also been characterised by concerns with abortion: there have been highly emotive public protests against 'freezing babies', making no distinction between a human embryo, and a foetus. From a medical perspective... what is the difference, anyway? It is a continuum: you stick labels as you go along. When a baby is born, we call it a newborn baby... then we call it a toddler when it starts to walk a bit; then a child, then an adolescent, then an adult... there aren't clear defi- nitions: it's a continuum... By that argument, the protestors may have a point. If the definitions aren't clear, they can be stretched backwards as much as forwards... But then, science does give definitions. An adolescent, for example, is going to go through puberty. A baby has to have been born; before that, it's a foetus... which is not the same thing as an embryo. But you can take the argument back even further. Before you were an embryo, you were a sperm and an egg. And if we were to go on ethical issues: contraception was 'not right' be- cause it stopped the potential for that life. Even a sperm and egg, lying next to each other, can give rise to life. But what is an em- bryo? By day three, it will con- sist of about seven to eight cells. Those cells are all identical, and have the potential [to become an individual]; but they still have to give rise to a placenta... to mem- branes... eventually, to a foetus. Potentially, they could give rise to three foetuses. So how can you call that an 'individual', with its own identity? It could become three people... Fr Peter Serracino Inglott had made a similar argument some years ago: we cannot talk of an individual 'soul' for the same reason. But that's a case of applying theological reasoning to scientific issues. Is that a good way to approach this issue? No, I think it's very unfortu- nate. But one finds oneself com- pelled to do it, because these are the arguments being thrown at us all the time. I have been com- pelled to look things up, and – in a similar, in my opinion, ridicu- lous fashion – I have had to come up with comparisons. Muslims, for instance, believe that the soul starts at 40 days [from concep- tion]; in Judaism, it's when the organs start to form. I think it's useless to go down this route... but I feel I have to, because these are the arguments we face all the time... Nonetheless, there are other arguments which are less emotive. If the success rate with frozen embryos is high, we could end up with a surplus of viable frozen embryos: raising questions as to what to do with them in the long run... I think we have reached a point in this interview where I can say that I don't like the proposed amended law. It is still too re- strictive, and I really don't see why our citizens with fertility issues have to be second-class. The proposed amendment says that we will be able to attempt to fertilise five eggs... but not even the first time round. For the first time, you will only be allowed to attempt to fertilise three. I think that's incredibly ridiculous. So, if I have a situa- tion which is dismal – I can tell straight away that it's a hopeless situation – they're telling me that I have to subject that pa- tient to a whole cycle of IVF, to fertilise three eggs... just so that she might qualify for a slightly better chance with five. Why? [pause]. Even if we are to going to go with this super-restrictive idea, at least it should be the Embryo Authority to decide: I present the case, and they de- cide if it's a genuine case that can go straight for five embryos. Why should I have to compel somebody to go through all the hardships of a full IVF cycle, so that they can qualify for another chance? It seems to me that the reason for these restrictions is to appease the general public. Would you agree? Not even the general public. I would say it's to appease the objections of certain individu- als. Unfortunately, the people who are really going to need this therapy are not being consulted. The infertile population we have right now is not being consult- ed... and please note: it is at least one in six people... and expected to increase. One in six is not a small number. But they are not being consulted, mainly because they are not coming forward. The stigma is still there. We think of Third World countries where infertile women are cast out of communities, as some- thing disgusting – and it is – but we do the same thing here. A woman who is infertile still feels the taboo. And even more than that, they are scared to come forward because, if they eventu- ally do have a child through IVF, and people get to know about it... they are afraid that even their children will be stigmatised. That is why very few come out in public. But the ones who are really going to need it are not voicing their opinion. I think it's ridiculous that people who have had four, five, nine children feel empowered enough to impose on the childless, and tell them: 'Lump it. You're not going to have babies...' This seems to echo arguments made in Parliament recently, to the effect that legislators should not grant rights that have been 'denied by God and nature'. What is your answer to that? That argument throws away medicine in general. Let's say I have a strong family history of heart disease – my father died at 40, his brother died at 42... and I'm next in line. So I go and have an angiogram done, and find that my veins are a bit tight. So we put stints in them, and I end up living till I'm 70 or 80. I was not meant to live that long. My genes were meant for me to snuff it when I was 40... but medicine intervened. We do the same thing with disabled peo- ple. Do we throw them away? No. We care for them, medicine tries its best, etc. Same with re- nal failure. We don't give up on those cases: we try to obtain or- gans and transplant them. This is about medicine. And this concept, that infertility is 'just a luxury', is wrong. In Europe, infertility is a medical condi- tion. If you have a right to medi- cine, you have a right to medi- cal treatment for infertility. [...] The idea that this is just about women being capricious... wanting to have a child, because she 'would like to have one'... is wrong. That woman has a very basic, instinctive need to pro- create; and the inability to do so is a medical condition, and that is how it has to be treated. I really hate it when people talk about a woman 'desiring to have a child'. No. She might 'desire' to have a nice set of curtains... not to have a baby. The baby is an instinctive need, not a desire. PHOTOGRAPHY BY JAMES BIANCHI