Category: Malta

As a child I was fascinated with caterpillars. I would collect them and carefully place them in a small patch in the garden, which my uncle had planted with lettuce and cabbage so that these caterpillars would grow on it and I would be able to see how they changed into pupae and eventually into butterflies or moths. 

Later on, basic science showed me that caterpillars are the larval stage of the order comprising moths and butterflies and that the metamorphosis from caterpillar to pupa to butterfly involves the same creature. Science has no doubt that the caterpillar and the butterfly are in fact one and the same creature.

Likewise, the human embryo develops into a foetus, into an infant, a child and an adult while remaining one and the same human being.

 Thus the embryo is human from the moment of conception. His or her identity as human is entirely separate from his/her stage of development. He or she is not a potential human being but a human being with potential.

As such human embryos are not a bunch of cells but are human life – and these embryos have a right to live, and a right to be defended and protected.

I am irked when I hear people, including politicians, journalists and people in the street, speak of “l-embrijuni żejda”. Żejda can be translated as surplus, spare, leftover or even unwanted.

How can we speak of human life in such a way, especially if we attach this argument to the one of equality?

The discrimination is not only a linguistic one. For instance, are we not discriminating between the embryos when we are treating some of them as spare, just in case the first implantation is not successful? Are we not discriminating between embryos when we know that the thawing process results in the death of one in three of them?

Are we not discriminating between embryos when we are choosing to implant some in their own mother’s womb and freeze the others? Are we not discriminating between the embryos when one or more of them is raised by his/her natural parents while the others are given for adoption? Are we not discriminating when we are deliberately separating siblings from one another?

I can understand the position of those couples who yearn to be parents. I even empathise with them because I too yearned to be a mother and to have a family. I understand that IVF may be the only solution in some cases. In fact I was in favour of the original Embryo Protection Act because it was meant to regulate the process of IVF and to protect both the couple and the embryos.

I am aware that this act foresees the freezing of embryos in the very rare circumstances when, for instance, the mother has an accident or is ill, during the incubation period. Nevertheless, I cannot agree to the proposed amendment to this Act.

What I cannot agree with or accept is the deliberate creation of additional embryos, the deliberate discriminating process of choosing who to be implanted in the mother’s womb and who to freeze, the deliberate adoption of some of these embryos and the deliberate separation of siblings.

Admittedly there are couples whose only hope in having a child is IVF. The process of harvesting eggs from a woman is a long and painful one. The first, or even subsequent cycles of IVF, may not be successful.

Yet science offers the very good alternative of oocyte vitrification, that is, the vitrification of the unfertilised eggs. These eggs, unlike the embryo, are indeed a bunch of cells. Thus the process of oocyte vitrification does not pose any ethical dilemmas and scientifically yields the same, if not better, success rates.

So my question is why are we resorting to embryo freezing when there is another, ethically acceptable solution?

My contribution here is certainly not linked to any political opinion or position. It is my position as a free person who has no political allegiances and whose purpose is to defend and protect human life.

It is for this reason that I call on legislators of goodwill, on men and women whose purpose is the well-being of society.

I call on them to stop this amendment and seek better ways and means to assist couples in having a child.

Carmen Zammit is a theology graduate.

The proposed amendments to the Embryo Protection Act have been described as “a complete travesty of ethics, morality, and human dignity, allegedly to remove ‘discrimination’ imposed by nature herself”. The discussion on Xarabank further illustrated how media manipulation can obscure what the proposed amendments mean to the man in the street.

This law is not about looking out for ways in which the rare cases present and can be helped within the limits of the law, but about using these people and hiding the true objective of the Bill.

We all feel for and agree that patients suffering from infertility need help and that we are obliged to have the best practice ethical medical support possible available. Furthermore this should be free of charge. At present the couples still have to foot bills for medicines they may not afford.

It is well established by science and endorsed in our law that the human embryo must be protected from conception. We must heed the cries of the infertile couple but must also have the best interests of the children born from IVF at heart.

The human embryo is one of us. We were all embryos, small voiceless and vulnerable. It is a stage in our human life, as is the preborn, infant child, adult and elderly. The present law endorses and protects the embryo and only considers freezing when it is the only way to save an embryo’s life in extreme cases.

The new law will offer freezing as an option not an exception. The freezing of embryos constitutes an offence to human life, suspending this life and subjecting it to the dangers of thawing. Many embryos remain frozen, unclaimed and end up losing their lives in all freezing facilities worldwide.

This law is about “giving children to all who want a child”. They can be single men, women or in relationships. It is not discrimination that prevents same-sex couples from having a child but Mother Nature. It is not discrimination that prevents a single man or a single woman from conceiving without a partner but nature.

Children need a biological mother and a biological father to be conceived.

Knowing our identity and family bonds is essential to our well-being. We have all seen TV shows of adopted children who love their adoptive parents but who go on a quest to find their biological parents. We have seen the reunions and been emotionally touched by this.

This Bill proposes the opposite. It proposes creating a generation of children to purposely have an unknown father or unknown mother by anonymous donor conception. It deprives them of having any means to know if they have brothers or sisters.

The voices of the children born from these techniques, now adults must be heard. They too speak of the pain in being abandoned by their biological parents in the quest to have a child. Conveniently, these adults were dismissed as “the exceptions” by gynaecologist Mark Sant, who only uses the exception when it suits his arguments.

This extract is from an e-mail from Olivia Pratten who eloquently says:

“As someone conceived from paid anonymous gamete donation, I am outraged to read that Malta is considering allowing the practice. I advocated ending the practice in Canada for many, many years. I presented at both the House and Senate Committees of Health in Canada in multiple testimonies given between 2001 and 2004, and also in court and publicly from 2008 to 2012 – arguing successfully at the BC Supreme Court to end anonymity.

“I know this issue inside and out (and have lived it) and it is shocking that Malta would consider allowing anonymity when so many other jurisdictions have ended it (UK, Sweden, Australia, etc). It is absolutely not in the best interests of the resulting children to allow it.

“I spent 30 years of my life having no idea which one of the thousands of strangers I walked by every single day was my biological father. It was awful. Yes, I had a dad and a great family, but that didn’t change or replace the fact that my biological father was a complete unknown and I was created to be disconnected from him and my paternal family.”

The amendments proposed allow us to create children from men or women who are already dead but had donated sperm or ova creating orphans at birth.

They do not provide safeguards against brothers and sisters who will be attracted to each other and not know they are related. The law proposes to solve this by allowing one donation but this does not mean that whoever donated will not have his or her biological children as well.

The proposed amendments are a travesty of justice in presenting concepts like unknown father and unknown mother as beneficial to society. We cannot allow this to happen.

Members of Parliament endorsing this carry a heavy responsibility. They are accountable to the pain that will be inflicted on a new generation.

My appeal is to join the movement for life to show our dissent.

Our children deserve better. #embrijunWiehedMinna

Miriam Sciberras is chairman, Life Network Foundation Malta.

In his article of embryo freezing (January 27), Martin Scicluna chose to confuse the debate by dragging in partisan politics and religion. Half his article focused on the disparate views different religions have on ensoulment and at what stage of one’s existence one acquires a soul. This is just a red herring and totally irrelevant to whether an embryo is a human life entitled to be defended.

He complains that we are subject to Catholic morality and drags in the issue of paedophilia to insidiously suggest that evil behaviour by certain members of the Church therefore disqualify its participation in any debate on ethics and morality.

To discredit pro-life movements, he attributes to them arguments they do not hold and then dismisses them as the fruit of sentiment and presumably of superstition.

Scicluna should realise that the Embryo Protection Act was the fruit of months of intense debate and study at every level and that included legal, medical, political and ethical considerations. In short, it was exhaustively reasoned out after considerable and rational consultation.

The success rate of IVF governed under this protocol has proved satisfactory and equivalent, if not better, than IVF that used embryo freezing. As a regular columnist, Scicluna might take the trouble to read the report published recently by a team of hiaghly-qualified experts in various fields who defended the Embryo Protection Act by concluding that changes are not reasonable nor necessary.

If this sounds like mumbo jumbo, or some form of coercion by a domineering Church, he is either uninformed, unfair or has ulterior motives to play up to the whims and vested interests from certain quarters.

Scicluna should know that in the so-called progressive Western world, money talks and reproductive technology is highly lucrative, consumer driven and market based, and that children are increasingly being regarded as commodities.

Unlike Scicluna, pro-life NGOs do not favour an attitude which will have a long-term negative impact on how we value life.

When pro-life groups draw the public attention to the intrinsic worth and human dignity of embryos and to the grave risks of devaluing life once they are not given the safeguards they deserve, the public is not being misguided. An embryo is not an ovum, nor a spermatozoon nor any kind of living cell.

The great endocrinologist and research scientist, George W. Corner, described the creation of an embryo by the fertilization of an egg by the sperm as one of the greatest wonders of the world, describing it as a “spectacle that can be compared only with an eclipse of the sun, or the eruption of a volcano”.

Of the bands of the spectrum of our life, the embryonic stage is the most momentous and dramatic, yet is overlooked because it occurs at a microscopic level. To place an embryo on the same level as other human cells is the fruit of crass ignorance or a deliberate attempt to misinform the public.

Every stage of the development of a human being is of profound significance, be it at the earliest and most critical stage of embryonic life or that of an elderly person with failing health.

Peddling the argument of personhood is a cheap attempt to deny the rights of the embryo.

One’s freedom ends when other’s rights are placed at risk. The weak and the vulnerable deserve more robust legal protection because they cannot defend themselves. To legislate laws to undermine this reasoned principle is patently unjust.

One does not need to be religious to reason things out. And the truth is not determined by the number of people who uphold it. The inviolability of our human dignity ought to be a non-negotiable pillar of ethical regulations.

Such a core value should not be surrendered to the mood of majority decisions.

History has shown us where such flawed reasoning has led us. Abortion is one of the fruits of such thinking and has resulted in the decimation of Western society.

One hopes that as a truly secular society we will not confuse issues by dragging in caricatured portrayals of religious belief and instead stick to sound rational arguments.

The ongoing news concerning the murder of Daphne Caruana Galizia represents a huge taint on Malta’s governance. The way the government is acting is more in sync with that of illiberal democracies in Hungary, Poland and Turkey, where institutional autonomy is being dismantled to protect political oligarchs.

Amid this dark cloud over democracy, Joseph Muscat’s government is trying to rush through legislation and avoiding thorough public debate and scrutiny. IVF and surrogacy are the most recent examples.

The government is stating that in vitro fertilisation (IVF) will be accessible to more than just different-sex couples; infertile couples will have increased chances to conceive a child. Consequently, embryo freezing will be permitted, prospective parents can have extra embryos frozen for five years and these may be consequently given up for adoption.

The proposed law will also allow sperm and egg donations, as well as surrogacy. As things currently stand, surrogacy is illegal, and doctors involved in IVF or embryo transfer can be subjected to a fine ranging from €5,000 to €15,000 and a maximum three-year prison sentence. The surrogate mother’s punishment is decreased by one or two degrees.

The proposed law will keep such punishments in place for surrogacy against payment, but it can allow ‘altruistic’ surrogacy. In turn, this part of the law will be subject to ‘public consultation’ and a legal notice.

Judging by this government’s standards for consultation, my hopes aren’t too high.

Pierre Schembri Wismayer, a professor who was involved in the drafting of the existing IVF legislation is dubbing the proposed changes “chilling”, “irresponsible” and “as tantamount to a document prepared over the weekend by somebody high on energy drinks” (April 15).

He raised concern over the possible ‘blackmail’ of couples applying for IVF treatment to give away their own embryos for adoption if they are not required. He also raised concern that embryologists would select the best two embryos out of the permitted five for IVF treatment for a higher chance of success.

In his words, “the rest, which will be frozen, will in actual fact be less healthy embryos. This will further reduce the chance of these embryos being adopted”. 

He also raised concern about contradictions in the proposed text and lack of safeguards, which are not surprising in a country with poor checks and balances. This could have implications in areas such as children’s rights and health. 

I augur that other experts in the medical and social sciences speak up on the proposed legislation. Irrespective of one’s ideological and ethical positions on IVF, surrogacy and related issues on the Malta parliamentary agenda, I believe that broad, informed, non-banalised and comprehensive debates are required within the public sphere before laws are rushed through.

I, for one, have strong ethical reservations on surrogacy, and this view is shared by a wide range of ideologies ranging from feminism to Catholicism. In many European countries it is banned, while some others permit the so-called ‘altruistic’ model. The European Parliament has called on States to ban it.

In my reading surrogacy legitimises the commodification of the body through exploitation and abuse. The woman’s womb becomes a factory, the mother cannot be called ‘mum’ and the rights of the child are practically inexistent. The client comes first. This argument even holds for ‘altruistic’ surrogacy.

Indeed, how would we know if such surrogacy is really altruistic, that no pressure has taken place and that no money is being paid in a clandestine way? And why is the government assuming that no-cost surrogacy is not exploitative? Is the government consulting research on the demographics of surrogate mothers?

Does it look into the possibilities that the latter may have less social power than their clients?

The plot thickens. What if the surrogacy doesn’t go according to plan and the prospective child does not fulfill the expectations of the clients?

To me it is inconceivable that the same government that calls itself feminist is practically brushing aside ethical concerns and avoiding informed debate on such matters. We are moving towards a soulless State where the government’s niche products involve the commodification of everything.

The human body is the latest addition to citizenship, nature and public land.

Ref: https://www.timesofmalta.com/articles/view/20180423/opinion/The-IVF-surrogacy-debate-Michael-Briguglio.677192

It is becoming a habit of this progressive government that when it wants to introduce a change, it precedes its actions by thinking up a story, a narrative that is essentially a false one. We have it from Minister Helen Dalli’s own mouth that when she wanted to bring in changes to the marriage and family laws she took everyone for a ride by creating a false narrative on equality. It seems that on the issue of IVF and embryo freezing, the government wants to do the same. The narrative it is creating is a false one in order to allow it to bring in changes to a law passed just six years ago by consensus of Parliament and passed by a PN government which, contrary to the false narrative, was very interested in helping couples have children but not at the cost of sacrificing human lives. The current false narrative is that the law is not good enough and to have a successful IVF rate we need to introduce embryo freezing and therefore, the law needs to be changed.

When examining things called facts and statistics however, this false narrative of the government is not borne out. In Britain, which is the doyen of IVF technology (remember Louise Brown), the success rate of pregnancy per embryo transfer (PETR) using both embryo freezing and fresh eggs is about 33 per cent. In the whole of Europe, the rate is about 30 per cent. In Malta according to official statistics, using both fresh eggs and frozen eggs the success rate is above 30 per cent. Now this does not mean that all implanted eggs will be carried to term. The take home baby rate varies with each country and depends on the expertise of the local centre and other factors like whether they are allowed to do pre-implantation genetic diagnosis (PIGD) or not. In many countries, a weakly developing embryo or an embryo with a genetic defect such as Down’s syndrome is not transferred so success rates are obviously higher. In Malta, this is not allowed and all embryos formed have to be transferred to the uterus and none discarded. Therefore, the reality is that our centre, which is only six years old, is having a PETR rate which compares favourably to the European standard. So in effect, it is not true that to increase IVF rates we need to bring in embryo freezing. We can have successful IVF rates using fresh and frozen eggs (oocytes) alone as is obviously the case seen.

The second false narrative being built around the lie is that to have sperm donation or surrogacy carried out by heterosexual or homosexual couples, one needs to bring in embryo freezing! The reality is that just as left over embryos may be used to donate to couples, so can left over frozen eggs. The use of embryo freezing is not required to achieve this. Not that I agree with surrogacy or gamete donation due to the dangers brought about by the commodification and commercialisation of children and modern slavery of both women and children.

The embryo is a human being from the zygote stage onwards in an active state of development. This is proved and determined by science, the science of embryology. Being a human being the embryo ought to be protected by society and individuals. As an innocent human being, it not only has a right to life but an absolute right to life. It is a prima facie right to protect human life at this stage and a wrong to destroy it whatever the reason, even if one had to argue that success rates in IVF might be improved by some rare procedure, though this is obviously not the case.

So what, one may ask, is the reason for the false narrative by the government? First, the government may be out to compromise the principle in the above paragraph, just because once compromised, this principle is jettisoned and then the next step becomes legally feasible, and the next step being abortion itself.

The second reason for the false narrative is that once gamete donation and surrogacy are brought in, the government does not trust couples to donate them to third parties! As long as the main issue remaining for couples, undergoing IVF is destroying frozen eggs or sperm, since there is no moral/ethical problem with doing this; many couples would rather do so than donate these gametes to any third parties. Very few people want their children running around under other people’s legal and social jurisdiction. Therefore, the government fears that since there will not be enough embryos for donation, it needs to create a scenario where extra embryos are left over from IVF procedures, which embryos are frozen and can then be used for donation to third parties. So much so, that the state intends to force parents to give up rights to any frozen embryos which become the wards of the state which state disposes of them as it sees fit. An abomination in itself!

Those in favour of preserving life are not against helping couples have children through IVF procedures or those procedures of assisted insemination, though this is what we are falsely led to believe. It fits in with the false narrative by the state. They are however in favour of doing so in a way that is ethical and respects and protects human life and human dignity such as in the current IVF law. Freezing embryos is against human life and human dignity. A good percentage of embryos are destroyed in the freezing/thawing process and many remain unclaimed by couples and frozen permanently, until the freezer is switched off that is. One cannot ever force couples to take them if they do not want them especially if they have enough children. Consequently, there are around two million leftover embryos frozen around the world. A frozen parallel humanity! For the Labour government however, ethics and the truth it seems, are words which like many required answers, are blowing in the wind!

Dr Asciak is Senior Lecturer II in the Institute of Applied Science at MCAST

Ref: http://www.independent.com.mt/articles/2018-04-22/newspaper-opinions/How-a-false-narrative-becomes-a-drama-6736188533

It might seem obvious to some but not to others, that the life of a human individual begins at conception. Academic research in this field has been very enlightening and it can be neither disregarded nor refuted, unless one consciously decides to dwell in a convenient cloud of unknowing. Alternatively, one could admit that scientific studies point to conception as the moment of inception of human life, but still maintain that the reproductive “rights” they advocate for override the right to life of the unborn.

We will attempt to remove certain obfuscations related to this issue by presenting real scientific evidence concerning conception and human beings in order to do away with pseudoscience. This clarification is both important and crucial, because an unnecessary grey area has been conveniently created. The scientific evidence available confirms that any negative action taken vis-à-vis the fertilized ovum from the moment of conception is an action directed against a human individual. This logically goes against the Hippocratic Oath in the medical field and many fundamental values of humanity.

It is hoped that the scientific evidence presented here will encourage the defence of the unborn from the instant of conception to the moment of birth, in all aspects of legislation and policies. This would include the provision for clear definitions referring to the unborn child and the avoidance of vague terminology to avoid subjective interpretation that may lead to abuse. The scientific literature that will be presented supports the definition of an embryo in the Embryo Protection Act (Cap. 524 of the Laws of Malta), which is quite accurate and cannot be considered outdated. This definition states:

“embryo” means the human organism that results from the fertilisation of a human egg cell by a human sperm cell which is capable of developing and shall further include each totipotent cell removed from a human embryo or otherwise produced, that is assumed to be able to divide and to develop as a human being under the appropriate conditions”.

A quick glance at some pivotal statements by heavyweight authors and researchers in this field is in order. The following are taken from very recent editions of medical text books on human embryology and reproduction and peer-reviewed scientific literature:

• “Human development begins at fertilization, when a sperm fuses with an oocyte to form a single cell, the zygote (one cell embryo). This highly specialized, totipotent cell (capable of giving rise to any cell type) marks the beginning of each of us as a unique individual.” (The Developing Human: Clinically Oriented Embryology, Saunders 2016).
• “[The zygote], formed by the union of an oocyte and a sperm, is the beginning of a new human being.” (Before We Are Born: Essentials of Embryology. Saunders, 2008).
• “Although life is a continuous process, fertilization… is a critical landmark because, under ordinary circumstances, a new genetically distinct human organism is formed when the chromosomes of the male and female pronuclei blend in the oocyte.” (Human Embryology and Teratology. Wiley-Liss, 2001).
• “Human pregnancy begins with the fusion of an egg and a sperm within the female reproductive tract.” (Human Embryology and Developmental Biology. Elsevier, Saunders, 2014).
• “Representing the 60 trillion cells that build a human body, a sperm and an egg meet, recognize each other, and fuse to form a new generation of life.” (The immunoglobulin superfamily protein Izumo is required for a sperm to fuse with eggs. Inoue N. et al. Nature, 2005).
• “The seminal question in modern developmental biology is the origins of new life arising from the unification of sperm and egg.” (Gene expression during the oocyte-to-embryo transition in mammals. Evsikov AV, Marín de Evsikova C. Molecular Reproduction and Development, 2009).
• “Fertilization–the fusion of gametes (sperm cell and oocyte / egg) to produce a new organism – is the culmination of a multitude of intricately regulated cellular processes.”(Fertilization. Marcello MR et al. Advances in Experimental Medicine & Biology, 2013).
• “The oocyte-to-embryo transition refers to the process whereby a fully grown, relatively quiescent oocyte undergoes maturation, fertilization, and is converted into a developmentally active, mitotically (a method of cell division, in which the nucleus divides into daughter nulei, each containing the same number of chromosomes as the parent nucleus) dividing embryo, arguably one of the most dramatic transitions in biology.” (The oocyte-to-embryo transition. Robertson S., Lin R. Advances in Experimental Medicine & Biology, 2013).
• “Fertilization occurs when sperm and egg recognize each other and fuse to form a new, genetically distinct organism.” (Juno is the egg Izumo receptor and is essential for mammalian fertilization. Bianchi E. et al. Nature, 2014).
• “Mammalian life begins with a cell-cell fusion event, i.e. the fusion of the spermatozoid(sperm cell) with the oocyte” (State of the art in cell-cell fusion. Willkomm L., Bloch W. Methods in Molecular Biology, 2015).
• “New parents anticipate their job begins at birth. Little do they know they have been exerting control within the baby’s first cell since fertilization.” (Parental Control Begins at the Beginning. Chu D. Genetics, 2016).

From the above it transpires that the immediate result of a sperm-egg fusion is a unicellular totipotent embryo. The fact that this embryo (the zygote) is a new cell type that is qualitatively different from its precursors (the gametes) and that, being a new organism, behaves in a very distinct way is an objective, verifiable piece of data that is scientifically evident. Without the influence of any external factors, the zygote sets a process in motion whereby, within minutes, other sperm are not allowed to attach themselves to its surface. This new organism, having characteristics that are different from mere cells, hence immediately embarks on a process of self-directed maturation. The Merriam-Webster dictionary defines an organism as:

“(1) a complex structure of interdependent and subordinate elements whose relations and properties are largely determined by their function in the whole and (2) an individual constituted to carry on the activities of life by means of organs separate in function but mutually dependent: a living being.”

Rather than being a mere collection of cells or human parts, human beings (which are by nature organisms) have a characteristic molecular composition and a specific way of behaving, aptly carrying out the activities of life in a coordinated fashion. Unlike other human cells which may assemble to form certain tissues or structures, the one-cell stage embryo that is the zygote, has the inner capacity to develop into a fully unified human body. This capacity, known as totipotency, is unique to the zygote.

Some may react by saying that even stem cells and tumours exhibit these characteristics, but this is far from the truth because, unlike embryos, these are not organisms, and neither do they exhibit the kind of interactions seen within an embryo which ensure its survival and development. It is an empirically proven fact that the embryo fashions itself and independently directs its development. It is incorrect to apply the term “totipotent” to any cell apart from the zygote, presuming that such cells can undergo an embryonic process leading to the formation of all the body components independently. Indeed, totipotency, or the ability to initiate an integrated developmental sequence, distinguishes a single-cell embryo from all other cell types. Consequently, embryos of all species are clearly organisms from the time of sperm-egg fusion onward, independent of the specific developmental mechanisms they employ.

In a study which observes embryos at a later stage (“Self-Organization of the Human Embryo in the Absence of Maternal Tissues”, 2016), the author states:

“Together, our results indicate that the critical re-modelling events at this stage of human development are embryo autonomous, highlighting the remarkable and unanticipated self-organizing properties of human embryos.”

Now we have scientific proof that the immediate result of a human egg-sperm fusion is a unique and autonomous human being with full developmental characteristics, meaning that human life is a continuum which begins at a specific point. Consequently, any practice or event which harms or terminates life at any point throughout the entire continuum, harms or terminates a human being.

A glance at embryo freezing (cryopreservation)

Embryo cryopreservation (embryo freezing) is a practice which may very easily subject human embryos to inappropriate and dangerous conditions. We will refer to studies originating from countries where there are decades of experience in this field. The following is an excerpt from the conclusions of a study published in the periodical Fertility and Sterility of the American Society for Reproductive Medicine (“The Social Implications of Embryo Cryopreservation”):

“Embryo cryopreservation has been increasingly used to improve the cost-effectiveness of in vitro fertilization (IVF) and expand the options available to infertile couples, yet its widespread adoption has occurred more rapidly than our ability to study the social consequences for the couples and health professionals involved. For maintaining cryopreserved embryos, the existing literature is fragmented and incompletely explores the effects on an infertile couple’s psychosocial health and personal relationships, their family planning strategies, or their preferences for the disposition of the embryos. Managing unclaimed embryos continues to create challenges for assisted reproduction professionals. We currently lack a thorough understanding of the numerous social implications of cryopreservation. Major areas for future research include the impact of stored embryos on couples’ fertility intentions and psychosocial health, factors that affect couples’ decisions about embryo disposition, strategies to minimize unclaimed embryos, and the consequences of oocyte/ovarian cryopreservation.

Should this concern, voiced in 2005, seem somewhat outdated (though it is not), more recent literature is available. In a specialized textbook titled Principles of Oocyte and Embryo Donation (2013) the authors reported:

“Although recipients approach their donor oocyte treatment with a desire to cryopreserve embryos for attempts at creating a genetic sibling in the future, most only return to use their cryopreserved embryos after failing their original fresh transfer.

In fact, the results of a study which is referred to in the same publication (“Fate of Cryopreserved Donor Embryos”. Knopman et al. 2009) are as follows:

Analyzed were 829 fresh donor embryo transfer cycles performed during the study period of 1/2000–12/2004; 444 recipients delivered a viable infant(s) following a fresh transfer. Of these successful women, 177 (40%) had supernumerary embryos cryopreserved; however, only 37 (21 %) returned for a donor frozen embryo transfer by August 2009. In contrast, of the 385 women who failed their fresh attempt, 128 (33 %) had supernumerary embryos cryopreserved and 111 or 87 % returned for a donor frozen embryo transfer by August 2009. Overall, only 49 % of the recipients with supernumerary cryopreserved embryos returned to use their embryos by August 2009. Calculations revealed that at the time of the study’s conclusion, approximately 222 embryos remained in storage without a disposition.

Furthermore, the authors aver:

Despite the desire to cryopreserve supernumerary embryos at the time of the fresh donor oocyte transfer, more often than not, patients do not return to use their surplus embryos. Analysts estimate that as of 2003, over 400,000 embryos from all sources remained in storage facilities in the United States. As the number of IVF procedures has only grown over the past decade, we speculate that this number has nearly doubled.

But what happens to these “extra” embryos? Reference to a qualitative interview study of 58 couples (“Parents’ Conceptualization of their Frozen Embryos Complicates the Disposition Decision”. Nachyigal et al.2005) clearly indicates what fate they usually have:

“At the time of the interview, 42 (72 %) of the couples had neither made a decision nor were in the process of making a decision regarding their embryo disposition. Of the 16 who had made a decision regarding embryo disposition, 7 had donated their embryos to research/science, 5 had their embryos destroyed, 2 donated their embryos to another couple, and 2 used them for another attempt at pregnancy.”

Another country where there are decades of experience in cryopreservation is the UK. In 2011 Lord Alton of Liverpool asked Her Majesty’s Government (in Parliament):

“…..whether they now collect data on how many human embryos have been (1) created, (2) frozen, (3) destroyed, (4) implanted, and (5) experimented upon, since the passage of the Human Fertilisation and Embryology Act 1990; if so, what are those figures; and, if not, whether they will instruct the Human Fertilisation and Embryology Authority to refine their collection of data so that it provides full disclosure under each of those categories. [HL4176]”

The answer is, at least in our view, quite disconcerting, and it does not look good for embryos:

…The Human Fertilisation and Embryology Authority (HFEA) has advised that the data it holds in relation to human embryos that have been created, frozen, destroyed and implanted are set out in the following table. It does not hold data in relation to embryos experimented upon…..

 

Embryos Frozen				Embryos Discarded		Implanted
Embryos created	Embryos stored for the patients use	Embryos stored for donation	Embryos stored for research	Embryos reported on the Treatment form as being discarded	Embryos reported on the Gamete Movement form as being removed from storage and discarded	Embryos transferred	Gestational sacs observed
3,546,818	839,325	2,071	5,876	1,691,090	23,480	1,388,443	235,480
HFEA Human Embryo Data—Cycles from 1 August 1991 to 31 December 2011

Source: Human Fertilisation and Embryology Authority

Effectiveness, usefulness and benefit of embryo freezing

All this being said, is embryo freezing as effective and useful as was previously perceived? A study published this year by the Yale School of Public Health and co-authors in China found an insignificant difference in life birth rates between IVF with fresh embryos and the cryopreservation method. The study, titled “Transfer of Fresh Versus Frozen Embryos in Ovulatory Women”, is a multicentre, randomized, controlled trial and was published in the New England Journal of Medicine. It concluded that:

“The live-birth rate did not differ significantly between fresh-embryo transfer and frozen-embryo transfer among ovulatory women with infertility, but frozen-embryo transfer resulted in a lower risk of the ovarian hyperstimulation syndrome (0.7% vs 2%)…..There were also no significant between-group differences in the rates of implantation, birth weight, clinical pregnancy, overall pregnancy loss, and ongoing pregnancy…. The risks of obstetrical and neonatal complications and other adverse outcomes did not differ significantly between the two groups…. Our previous trial involving women with the polycystic ovary syndrome, which used a protocol that was nearly identical to that used in the present trial, showed favourable effect of frozen-embryo transfer on the rate of live birth. The reason for the discrepant results in these two populations is uncertain”.

Not even experts from major health institutions are certain about the effectiveness, usefulness and benefits of embryo-freezing. Hence, putting human beings in harm’s way despite the fact that the “benefits” there might be, as indicated in this study, are less and less promising, is highly questionable.

In another study (Comparison of Pregnancy Rate between Fresh Embryo Transfers and Frozen-Thawed Embryo Transfers Following ICSI Treatment) published in the International Journal of Reproductive BioMedicine in 2016, results were quite similar:

“There was no significant difference between biochemical pregnancy rate, gestational sac, and fetal heart activity in fresh ET and FET cycles.” It is true that the authors of this study say that “…the embryos are able to be stored for subsequent ART [Assisted Reproductive Technology]”.

Nevertheless, the aforementioned potential harm, namely the discarding and destroying of embryos, that goes hand in hand with cryopreservation, indeed remains.

Given the nature of this practice and the statistics available, it is clear that what is at stake is the life of a human individual. Stunting the embryo’s growth or disposing of it as a result of a production that has exceeded demand is tantamount to destroying human life.

Jean Pierre Fava Dip., B.Sc. (Hons.), M.Sc. H.Sc. Health Scientist

Maureen L. Condic, Ph.D. is an Associate Professor, Neurobiology and Anatomy University of Utah, School of Medicine. Since her appointment at the University of Utah in 1997, Dr. Condic’s primary research focus has been the development and regeneration of the nervous system. In 1999, she was awarded the Basil O’Connor Young Investigator Award for her studies of peripheral nervous system development. In 2002, she was named a McKnight Neuroscience of Brain Disorders Investigator, in recognition of her research in the field of spinal cord repair and regeneration. Her current research involves the control of human stem cell potency and differentiation. In addition to her scientific research, Dr. Condic teaches both graduate and medical students. Her teaching focuses primarily on embryonic development, and she is Director for Human embryology in the University of Utah, School of Medicine’s curriculum. Dr. Condic has a strong commitment to public education and science literacy.

 

Helena Grech Sunday, 22 April 2018, 16:47

A massive crowd gathered on Sunday afternoon to protest against the government’s proposals to introduce embryo freezing tied with anonymous adoption.

People held placards saying ‘I am not an object’ and ‘don’t freeze me’.

The “manifestation” has been organize by pro-life group ‘The Life Network’, who were also against the Morning After Pill which was legalized last year.

 

Mixja favur il-Ħajja from The Malta Independent on Vimeo.

Many older people were in attendance, together with many religious people, priests and nuns. 

Parliament is debating government proposals to introduce embryo freezing tied to anonymous adoption, open up IVF to gay couples and individual people, and therefore would launch sperm and ovum banks. A decriminalization of non-commercial surrogacy is also being proposed.

It is understood that protestors mainly take issue with the “objectification” of human life through embryo freezing and the ethical implication tied to anonymous adoption of embryos.

Those in attendance held white flowers to represent the “babies” which do not have a voice. One woman said the flowers represent the embryos who would be frozen.

The flowers are to be placed in front of parliament as a message of protest.

In comments to this newsroom, one protestor remarked that embryos are not objects, and human life is not being respected through the freezing of embryos.

Other placards read “shouldn’t I know who my mother is?”

The crowds sang ‘hallelujah’ along with a band present. There was a light atmosphere with everybody singing and clapping hands.

Protestors left Castille square to walk Merchant street. They turned onto Republic Street and placed flowers in front of Parliament building, which was cordoned off by police barriers. 

One nun could be seen holding baby shoes to “give a voice to the unborn”.

Miriam Sciberras, a prominent pro-life advocate asked protestors to place single baby shoes in front of Parliament to signify all the embryos that will be frozen. 

Nationalist Party Leader Adrian Delia was in attendance, in addition to former leader Simon Busuttil, MPs David Agius, Clyde Puli, Robert Cremona, Kristy Debono and her husband Jean-Paul Debono. 

Leader of the Patrijotti Maltin, Henry Battistino was also in attendance. 

Miriam Sciberras encouraged protestors to take a ‘selfie’, upload it to Facebook accompanied by the hashtag ‘MovementForLife’. 

Thousands gathered before Parliament to show their opposition to the proposed embryo freezing legal amendments. 

The first speaker, Dr Joseph Mizzi said he is in favor of life and he is not alone. He stressed couples facing fertility issues deserve support and IVF treatment. He said he is against embryo freezing, because it goes against the rights of parents and babies themselves.

He said that embryos will be viewed as products, with some chosen to be born and some arbitrarily chosen to be frozen. 

He said many of the frozen embryos end up dying, and for those which are adopted , this is discrimination by the parents. 

A married man with two children spoke at the protest, who had been born in an institute and adopted by a Maltese women. He spoke of how a chapter in his life remained open until he found his biological parents, despite having a lot of love at home. Protestors are against anonymous adoption of embryos because they feel the embryo is being discriminated against and that it has a right to know who it’s biological parents are.

A British doctor named Joanna Ross, who Miriam Sciberras said is a sibling of about 300 people as part of anonymous embryo protection, addressed the crowd. She spoke of her sadness about her children not knowing who their maternal grandparents are due to anonymous embryo adoption. 

She called anonymous donor conception a “social experiment”, saying it is not normal.

“Anonymous donation is so wrong,” she said.

She spoke of the problems of not knowing our genetic family when health issues arise and medical donations are needed. 

Health Minister Chris Fearne had said if the adopted embryo is born, when it reaches the age of 16 it would have access to the medical records of their genetic parents would be made available. 

Miriam Sciberras took the stand to say the issue goes beyond partisan politics, adding that the majority of people in Malta are in favour of protecting human life.

She said that embryo freezing is only acceptable in exceptional situations, as is currently the law.

Ref: http://www.independent.com.mt/articles/2018-04-22/local-news/Give-a-voice-to-the-unborn-massive-protest-against-government-proposals-on-embryo-freezing-6736188593

The complexity of the fraught human realities of childless couples has been all but lost in the heat and dust that has been gene­rated by government’s IVF Bill. It is tempting to just shrug shoulders and say it is not my problem, that this is simply a decision for the would-be parents to make.

But I cannot. There is a third person involved. Embryos are voiceless, and this government’s IVF Bill is trying to make them invisible. Children, we used to be told, should be seen but not heard. By effectively removing the primary focus on the protection of the embryo, the government is relegating embryos to the status of non-persons.

Because this, at its core, is the most fundamental of four controversies surrounding the IVF proposals. The government has tried to pussyfoot around the issue of abortion for years. But in proposing embryo freezing, it has put the spotlight squarely on the nature of the embryo. One-third of frozen embryos die. On such matters of life and death there can be no equivocation. Does the government consider that life begins at conception, or not?

The second controversy revolves around the nature of parenting. The Bill separates the womb from the mother, not just in the exceptional cases of particular medical conditions, and not limited to a particular relationship between the mother and the owner of the womb. Surrogacy will be available to all, with hardly any safeguards that can be scrutinised by Parliament, as if this is a minor technical matter for the minister’s advisor to concoct. 

Nor will this Bill require prospective parents to be in a stable relationship (let alone marriage). A single person is entitled to IVF. Incredibly, the State will have stricter safeguards on parents for fostering than for IVF. And prospective parents freezing their embryos will be required to sign them off for adoption, a world first. Truly, fools are rushing in where wiser heads in more progressive countries are fearing to tread. 

The third controversy is about the nature of the State. The IVF law as it now stands is underpinned by the belief that the State has a paramount responsibility to safeguard the rights of the most vulnerable, and to mediate between competing claims in a sensitive manner that considers the common good and the path of least harm.

With the current Bill the government has effectively abrogated this responsibi­lity. It plans to reduce itself to a supermarket of reproductive services, for its voter-consumers to choose at will. The value of the life of the unborn has been replaced by the supreme value of the market: personal choice. If you want it, you can have it, so everyone (with a vote) is equal. So that’s all right then.

But there is a fourth controversy that the government could have easily avoided.  When Malta was convulsed with the debate on divorce, the discussion was passionate and at times intemperate, but it respected the right of all parties to have their say. The government of the day lost to the popular will, but did not lose its dignity because its position and democratic due process were completely above board. This helped to enshrine divorce not only in the statute books but also in popular culture.

But this government has resorted to subterfuge. The very title of the Embryo Protection Act has become a mockery, a smokescreen for the government’s real intentions.  On Dissett last week Health Minister Chris Fearne stated categorically that the selection of embryos to be implanted and to be frozen would be purely at random.

This is not true. Indeed, if a practitioner were not to select the most viable embryos for implantation, in the case of lack of success he could well be sued by his patients for malpractice. Was Minister Fearne lying?

Then there is the issue of timing. Bills with far less controversial and sensitive subject matter go through long months of public consultation and then parliamentary debate. Yet the government wants to pass the IVF Bill in two weeks, to coincide with the six-month anniversary of Daphne’s murder and the Daphne Project revelations. 

During the 9/11 attack in 2001 in New York, a UK government aide had suggested that this would be “a very good day to get out anything we want to bury”. Our government is engaging in an even more cynical political pincer movement. If the IVF Bill distracts people from the Daphne Project exposés, well and good. If the Daphne Pro­ject distracts people from the IVF Bill and government gets to burnish its faux progressive credentials to local and international lobbies, even better.

The Bill will finally land on the desk of President Marie-Louise Coleiro Preca, who last week addressed a Commonwealth conference on the rights of children. Will she sign it as it stands? She has a choice. We pray that she, at least, chooses to safeguard the unborn.

Ref: https://www.timesofmalta.com/articles/view/20180422/opinion/What-price-this-baby-Sandro-Spiteri.677083

Minister Chris Fearne has stated that the proposed amendments to the existing law that regulates IVF and grants protection to embryos “address one of the most powerful forces in human nature – the will to procreate and have a family” (Times of Malta, April 4). It is quite sad and ironic then, that the proposed legislation turns human procrea­tion into a totally unnatural act.

The Embryo Protection Act sought to regulate the use of technology wisely by restricting it to assisting infertile couples in a stable relationship. In doing so, it also protected the embryo’s dignity from the beginning of life and throughout their deve­lopment into childhood by making sure that they would be born and raised by their natural mother and father.

Not so in this proposed Act. Unashamedly, the proposed Act goes down the rabbit hole where not only does the embryo cease to have the lifelong protection of growing into and being sustained by their natural mother and father but it effectively makes redundant those natural family bonds, replacing them by the cold hand of technological procedure, registers and an (unspecified) “protocol”.

This Act turns the child – our hope, our future, those whom we, as a nation, love and invest in the most – into a commodity. By legalising gamete donation (access to sperm and ova from anonymous persons) and surrogacy (the renting of wombs), it reduces the child to a mere ‘object of desire’. Anyone who decides they want one, can ‘make’ one, by getting a piece from here, another piece from there, and whenever they feel like it, the semi-finished product can be taken out from storage and put into any stranger’s womb.

The child born from such a technocratic procedure would never be able to know who their natural mother is, who their natu­ral father is, whether they have any siblings, cousins, aunts, uncles, grandparents… maybe not even who carried them in the womb that gave them birth. They will be the ‘child desired’ by a ‘prospective parent or parents’, but nonetheless they will be orphans by design: the product of human ingenuity and adult self-interest. 

Gone is the human ideal that it is the love that binds man and woman who give birth to them as mother and father who take responsibility for their child. Now, our potential to father and mother (that is, our biological seeds of sperm and egg) is completely disconnected from our natural responsibility to father and mother the child whom we love into being.

The proposed law is telling us that it is perfectly fine to spread our seed and not care about the children that might or might not be born. Indeed, in its twisted logic, the proposed law dares to present as “generosity” the act of “donating” my seed while not caring about whether it will grow to become my child.

For the parenthood that the new law exalts is that grounded solely in an adult’s desire and choice. If I want a child, I should have the right to make one by whatever means possible – even if it defies all rules of nature that ultimately seek to protect the child’s best interest, and therefore the wellbeing of future gene­rations. But the proposed law is not interested in the child’s best interest or the wellbeing of future generations.

Also, let us not forget that the proposed Act intends by design to offer no guarantee that the child ‘made’ will be born at all. By opening the possibility of embryo freezing – and it is ‘embryo freezing’ not the euphemism “fertilised-egg freezing” intended to further depersonalise the child that has been conceived – a “prospective parent” or “parents” can make more embryos than they will ever “need” or “want”. In fact, freezing gives the option to change one’s mind about how many embryos one will, down the road, “need” or “want”.

And those frozen embryos that five, 10 or more years down the road end up being “not needed” and “unwanted” will simply be left suspended between life and death. Siblings conceived toget­her will be separated by the choice of adults who may once had wanted to be their “prospective parent” or “parents” but not any more. Some siblings will be chosen, others frozen (until another ‘use’ is found?) others may be donated to whomever might generously decide to give them an opportunity to grow. Those conceived at the same time could end up being born of different ‘parents’ five, 10, 15 or maybe more years apart… or (more likely) not at all.

For how many ‘prospective parents’ will be willing to take someone else’s ‘second best’ embryos? Will the State incentivise a ‘prospective parent or parents’ to give the opportunity to a ‘stored’ embryo to be born, over making a fresh batch from scratch with gametes of their choosing – whether their own, or taken out from a register with plenty of sperm and ova to choose from?

If we think we have entered a surreal world of child ‘making’, then we must also acknowledge that it can become the nightmare of a generation who will struggle with their personal identity because we have chosen to give them no family roots and therefore no personal history.

A child born from a frozen state through being ‘donated’ will trace their genealogy to a number in a lab record: to the medical history of an anonymous sperm donor (who might be dead before the child is even conceived), even a possible egg donor, maybe even the person who was willing to rent their womb.

This is to transform the gift of human life into a cold, calculative mindset that fails to appreciate how it is not the ‘putting together’ of a physical body that makes a child, but the long human journey of family connections and generations who, through many acts of self-sacrifice, loved him or her into being who he or she is today.

This new law proposes that we annihilate those family connections; that we make ‘blood’ obsolete. Instead, it gives us technological solutions and self-interested adult choice as the new ‘creators’ of future generations. Is this the kind of future we want for our children?

Nadine Delicata is a moral theologian and lecturer in the Faculty of Theology of the University of Malta.

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