Law 40 is 20 years old, 217 thousand children born in Italy

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Law 40 is 20 years old, 217 thousand children born in Italy

Equal to the population of a city like Messina or Padua. This is the number of children born thanks to medically assisted procreation (PMA) techniques since law 40/2004 came into force which regulates MAP in Italy and which turns 20 today, 19 February: there are 217 thousand, constantly increasing every year. The data collected by the National Register of Medically Assisted Procreation at the Istituto Superiore di Sanità, established by law 40, provides a snapshot of the Italy of Pma.

The numbers in the Registry indicate a reality that has become increasingly popular in our country: the number of treatments carried out every year has doubled, as have pregnancy rates, and procedures using cryopreserved embryos have also increased significantly. The average age of women who undergo PMA cycles is also growing: it went from 34 years in 2005 to 37 years in 2022 (in Europe in 2019 it was 35 years). The share of women over 40, which was 20.7% in 2005, reached 33.9% in 2022 (in Europe in 2019 it was 21.9%). Furthermore, in the period 2005-2022 the MAP activity increased almost twice, from 63,585 treatments in 2005 to 109,755 in 2022, and the percentage of children born alive in the general population which in 2005 was 1.22% in 2022 reached 4.25%. And again: ART procedures involving the use of cryopreserved embryos increased from 1,338 in 2005, equal to 3.6% of procedures, to 29,890 in 2022, equal to 31.1%. The relative pregnancy rate per 100 transfers performed increased from 16.3% in 2005 to 32.9% in 2022. Additionally, ART techniques using donated gametes increased from 246 cycles in 2014 (0.3%), to 15,131 cycles in 2022 (13.8%).

“In 2004 the Pma did not offer the possibilities of success that there are today – states Laura Rienzi, scientific director of the Genera centers for the diagnosis and treatment of infertility – the technology has evolved a lot both at a clinical level and within the embryology laboratories. The cryopreservation of gametes, the pre-implantation genetic test on embryos, the personalized hormonal stimulation protocols, are all achievements that the most advanced centers have achieved in these 20 years, allowing them to optimize the chances of success of Pma” . But the future opens up to new challenges, such as the use of artificial intelligence, big data, genetic tests for the study and prevention of infertility: “all frontiers – notes the expert – that we are exploring”. However, what is necessary, he adds, is “to increase the awareness and knowledge of citizens, as well as naturally increasing the offer of services throughout the national territory”. An “important goal to achieve, considering that the Pma could make a significant contribution against the continuous decline in births that we have been witnessing for years in Italy”. Law 40 has also proven to be “effective” according to the president of the Italian Society of Reproduction (Sidr) Ermanno Greco, but it needs to be “updated according to technological evolution, in particular the use of AI, genetic diagnosis on the embryo and fertility preservation techniques”. Critical, however, is the opinion of the Luca Coscioni Association, which underlines that there are approximately “14,000 children born per year after the elimination of the unconstitutional bans that the law provided for, such as the ban on heterologous Pma, on Pma for couples with genetic pathologies and for the production of more than 3 embryos”.

Therefore, “thanks to the achievements achieved with the intervention of the Constitutional Court – states Filomena Gallo, secretary of the association – since 2010, 14,000 children have been born every year who otherwise would never have been born”. Now, he concludes, “we will continue to resort to the courts to eliminate the last remaining bans: that of access to ART for singles and same-sex couples, and the ban on donating embryos unsuitable for pregnancy to research, as well as fight to arrive at a law for pregnancy in solidarity with others”.

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