Assisted Reproduction
Assisted reproduction, or artificial reproduction, is a reproductive medical technique through which two gametes are artificially combined.
Gametes are mature reproductive or germ cells and are divided into male (sperm) and female (ova).
Assisted reproduction is synonymous with assisted procreation.
We talk about homologous fertilization when the sperm and ova used belong to the couple of parents of the unborn child, from whom it will inherit the genetic heritage.
Assisted or artificial reproduction includes techniques such as intrauterine insemination, IVF, ICSI, MESE, TESA, etc.
To learn more about the various techniques used at the CMR (Center for Reproductive Medicine) and assisted reproduction, visit this link. Assisted reproduction can also be completed with PGT to transfer embryos free of genetic defects.
We speak of heterologous fertilization when the sperm or ova come from an external element to the couple.
This reproductive technique is currently allowed in Italy, thanks to amendments made to Law No. 40 of February 19, 2004, which contains the "Regulations on assisted procreation".
This law has sparked strong discussions about its "constitutionality", so much so that, since its inception, it has already ended up five times on the benches of the Constitutional Court - in 2005, twice in 2009, once in 2010, and once in 2012 - and seventeen times in total if we also include the rulings of the courts.
The last time was on August 28, 2012, when the European Court of Human Rights in Strasbourg reconsidered Law 40, ruling in favor of Rosetta Costa and Walter Pavan, who, being both carriers of cystic fibrosis, had requested to resort to assisted reproduction and preimplantation diagnosis.
On August 28, 2012, the European Court of Human Rights in Strasbourg reconsidered Law 40, overturning a ruling issued 19 months earlier by one of the chambers of the same Court.
In fact, in November 2011, the same Court issued a ruling that legally prohibited sterile couples from resorting to heterologous IVF. The ruling concerned two Austrian couples for whom IVF with sperm donation was the only possibility of having a child, thus claiming to be discriminated against compared to other couples who could use this technique.
This time the story involves two Italians, Rosetta Costa and Walter Pavan, who, following the birth of their first child, affected by cystic fibrosis, discovered that they were both carriers of the same disease.
This meant that if, as they wished, they wanted to have another child, they would have to deal with a 25% chance of being affected by the disease and a 50% chance of being a carrier.
Assisted reproduction and preimplantation genetic testing were the only options to avoid this risk, but Italian law does not allow it, which is why the couple appealed to the Court of Human Rights, arguing that the regulation violated their right to private and family life and discriminated against them compared to sterile couples and those in which the man has a sexually transmitted disease.
The Court issued the ruling, which became definitive in February 2013, despite the appeal from Monti and the Italian government, declaring the interference of Italian regulations on assisted reproduction in the exercise of private and family life as established by Article 8 of the European Convention on Human Rights.
According to the judges, the lack of consistency is determined by the fact that on one hand, Law 40 of 2004 prohibits the implantation of only embryos not affected by cystic fibrosis, while on the other hand, the law on abortion allows parents to abort a fetus affected by the same condition.
With the rejection of the government's appeal by the Court of Human Rights, Law 40 will need to be adjusted to the European Charter of Human Rights, providing access to medically assisted reproduction techniques even for fertile couples carrying transmissible diseases to their children.
According to the ruling, moreover, the Italian State will have to compensate the two spouses with 15,000 euros plus 2,500 in legal expenses.
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