Italian law on medically assisted reproduction: do women’s autonomy and health matter?

Abstract

BackgroundIn Italy in 2004, a very restrictive law was passed on medically assisted reproduction (MAR) (Law 40/2004) that placed Italy at the most conservative end of the European spectrum. The law was widely criticized and many couples seeking MAR brought their cases before the Italian Civil Courts with regard to pre-implantation genetic diagnosis (PGD), donor insemination and the issue of consent. Ten years on, having suffered the blows of the Italian Constitutional Court, little remains of law 40/2004.DiscussionIn 2009, the Constitutional Court declared the maximum limit of the number of embryos to be produced and transferred for each cycle (i.e. three), as stated in the original version of the law, to be constitutionally illegitimate. In 2014, the same Court declared as unconstitutional the ban on donor insemination, thus opening the way to heterologous assisted reproduction. Heterologous MAR is therefore perfectly legitimate in Italy. Finally, in 2015 a further ruling by the Constitutional Court granted the right to access MAR to couples who are fertile but carriers of genetic diseases. However, there is still much room for criticism. Many couples and groups are still, in fact, excluded from MAR. Same-sex couples, single women and those of advanced reproductive age are, at the present time, discriminated against in that Italian law denies these subjects access to MAR.SummaryThe history of Law 40/2004 has been a particularly troubled one. Numerous rulings have, over the years, dismantled much of a law constructed in violation of the rights and autonomy of women and couples. However, a number of troubling issues still exist from what is left of the law and the debate is still open at national and transnational level regarding some of the contradictions and gaps in the law highlighted in this article. Only by abolishing the final prohibitions and adopting more liberal views on these controversial yet crucial issues will Law 40/2004 become what it should have been from the start, i.e. a law which outlines the ‘rules of use’ of MAR and not, as it has been until now, a law of bans which sets limits to the freedom to reproduce.

Final destination of surplus cryopreserved embryos. What decision should be made?

“…Of the selected articles, most describe studies carried out in assisted reproduction centers, some in a university environment, from different countries and continents, with diverse legal and socio-cultural realities. The final destination of the SCE in most cases is not explicitly determined or specified in the law, when it exists, or in the regulations of the Medical Boards or assisted reproduction committees ( Riezzo et al ., 2016 ; Scott et al ., 2012 ; Souza et al ., 2018 ).…”

IVF and the Anti-Abortion Movement

“…Third, the law banned cryopreservation, or freezing, of embryos for future use. Much of the law in Italy has been dismantled in recent years (Riezzo, Neri, Bello, Pomara, & Turillazzi, 2016); however, the impact of the law provides a speculative window into what IVF practices in the United States could look like if life is defined as beginning at conception and a balance between embryo rights and reproductive justice is required. While IVF might still be legal, there are a multitude of negative consequences of limiting embryo creation, requiring embryo transfer, and outlawing cryopreservation.…”

Treating infertility: current affairs of cross-border reproductive care

“…Oocyte donation is forbidden by law in Germany, and IVF treatment is denied to homosexual couples [ 3 ]. In 2004, the Italian government passed a bill stating that only patients with reproductive problems attributed to sterility or infertility are allowed to receive medically assisted reproductive care [ 29 ]. On the other hand, countries like Spain and Belgium are a common destination for CBRC, due to their less restrictive legislation [ 21 ].…”