Translated from Italian – The original article may be accessed here.

I can remember a pair of girls, in secondary school, that became pregnant by 'accident', or unwittingly, maybe because they didn't know enough about the mysteries of human reproduction, or maybe because they were careless. I remember as well the solidarity, partly from compassion and partly from self-satisfaction, from those of us who in fact knew very well what could happen, and from then until now we've done everything to avoid becoming pregnant, usually without renouncing the so-called 'pleasures of the flesh', because we wanted the diplomas, the degrees, the careers, because we wanted to be able to go out with friends, to go to smoky bars, or stay out late in discotheques, we wanted to take adventure holidays, or go and drink in the fashionable bars, we wanted to be able to wake up with a hang over and stay in bed all day if it rained…

With the passing of time though, that murderous biological clock starts to make itself felt, helped by the fact that in the meantime you fall in love, maybe marry and settle down, like so many of our friends. You want to have a baby, and with the wisdom of a thirty year old you try to get pregnant.

Nine couples out of ten become parents, the rest become aware that there's something not working and have to join the ever-growing line of infertile couples, that worldwide, according to the W.H.O total around 80 million. A figure which doesn't differentiate between developed and developing countries, or between ages.

The first assisted procreation with a positive outcome which is officially recognised was in 1978, when , thanks to in vitro fertilization, carried out by British researcher Dr. Robert Edwards, Louise Brown was born in England. From then medicine has made huge advances in the field of so-called 'artificial' procreation, and various countries have had to modify their laws and regulations as a result. One of the last countries to legislate in this delicate area is Italy, more than 25 years after the birth of little Louise, the law 40/2004 has arrived with more than a little controversy.

Infertility

While researching this article, I had problems finding accepted Italian statistics. Infertility doesn't seem to be considered as a real sickness by the Italian ministry of health, in fact it's not included for example in the chapter Sickness and Health in the &ldquoReport on the public health 2001-2002”. According to information found on the portal 'Cerco un bimbo' (Looking for a baby – a much more informative source) &ldquoin Italy it's calculated that around 15% of couples that try to have a child, don't succeed”.

Infertility is generally defined as the incapacity to conceive after a period of unprotected sexual relations. The length of time which the couple must dedicate to these fruitless attempts before being defined sterile varies and can't be precisely defined, because the fertility of a woman diminishes for example with age and therefore, all other factors being equal, a woman of thirty five could physiologically need more time than a twenty year old to become pregnant.

What are the causes behind sterility in a couple? Professor Carlo Flamigni, a leading light in the field of Reproductive Physiopathology and Gynaecological Endocrinology, Professor of Obstetrics and Gynaecology at the University of Bologna, and expert in the field of Bio-ethics, outlines, in one of his publications (La procreazione assistita), that sterility can be in up to 35% of cases due to male problems, for 55% a female problem, and for 10% a problem with the couple or of an unknown cause.

While it's true that no one dies of infertility, a couple who wish to conceive can't be considered 'healthy', because between them often there are inevitable psychological repercussions and/or psychosomatic problems. Certainly, everyone has their own way of dealing with problems of this sort, and the experts counsel that, in these cases, there's a multitude of factors that can influence a couple from a psychological point of view. There are cases where the couple break apart, distanced by a sense of guilt or by the unspoken but reciprocal accusations. In other couples, the partners find in the desperation of not being able to realise their dream/need/instinct for procreation, a binding strength that keeps them from breaking apart, but at the same time prevents them from living a tranquil life together.

ART (Assisted Reproduction Techniques)

One possibility for infertile couples is Medically Assisted Procreation; this term groups together a number of Assisted Reproduction Techniques that range from the 'simple' induction of ovulation with the intention of artificial insemination, passing on to more sophisticated techniques, in which a certain degree of 'manipulation' is expected of the male and female gametes, as with the In Vitro Fertilisation with Embryo Transfer (IVF-ET) and Intra-Cytoplasmic Sperm Injection (ICSI). It's important, in the context of examining the law in Italy, to outline some of the technical details involved with Assisted Reproduction Techniques.

After a certain amount of preliminary analysis on both members of the couple, if the results confirm suitability, the next step is the operating phase. The first step is generally the suppression of the menstrual cycle of the woman, in order to then stimulate hormones that will promote the development and maturation of follicles. At this point the methods differ dramatically, notably, in so far as, in the simplest techniques once the mature follicle is obtained, the couple is sent home or at least to a place more convivial to the sexual act that 'has' to happen (otherwise the whole process will have been fruitless), in either FIVET or ICSI, the female eggs are collected transvaginally and fertilised in vitro The embryos that are thus formed are then transferred to the uterus, where it's hoped that at least one will implant itself and so give rise to pregnancy.