The 2004 Italian legislation regulating assisted reproduction technology: a multicentre survey on the results of IVF cycles

Ragni, G.; Allegra, Adolfo; Anserini, Paola; Causio, F.; Ferraretti, A. P.; Greco, Ermanno; Palermo, Roberto; Somigliana, Edgardo

doi:10.1093/humrep/dei011

Cited by 62 publications

(40 citation statements)

References 16 publications

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“…However other studies showed, in contrast to ours and other authors publications, that the new legislation neither reduced success rates of assisted reproductive technologies (ART) using fresh embryos, nor increased the multiple birth rate [9,10]. Moreover La Sala et al [12].…”

Section: Incontrasting

confidence: 64%

The Italian Experience of A Restrictive IVF Law: A Review

Setti¹,

Patrizio²

2012

J Fertiliz In Vitro

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In March 2004 the Italian Parliament enacted a Law (Law 40/2004) establishing a long list of restrictions for ART procedures. The law articles were constructed around the assumption of considering the embryo as a human being, with the same or even more rights of the woman or the couple seeking treatment for their infertility-related childless. In detail, the Law obliged to use only 3 oocytes to be fertilised and all the resulting embryos had to be transferred. Embryo freezing as well as pre implantation screening (PGS) or diagnosis (PGD) and sperm or oocytes donation were forbidden. In May 2009 the Italian Constitutional Court was called to judge parts of the Law 40 and cancelled some of the restrictions since they violated women's rights to have access to the best possible treatment with the lower health risks for both her and the future children. The Constitutional Court stated that the decision on the number of oocytes to be used for insemination, the embryos to be transferred and the embryos to be frozen were a matter of good clinical practice and under the full responsibility of the reproductive specialist. PGD and PGS remains a matter of debate because the Court was not called specifically to address this subject, although a clear opinion in favour has been expressed in previous decisions. The Constitutional Court will be called only in the future to express a judgement on gametes donation that is still forbidden. The present work reviews the clinical and social effects produced by 5 years of a restrictive ART Law (2004; the preliminary results after the Italian Constitutional Court decision (MayDecember 2009 and comments on cross border infertility treatment for procedures that are still barred.

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Section: Incontrasting

confidence: 64%

The Italian Experience of A Restrictive IVF Law: A Review

Setti¹,

Patrizio²

2012

J Fertiliz In Vitro

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“…Even if most Italian experts feel that the fertilization of just three oocytes could cut the success rates by about two-thirds (Turone, 2004), a recent study has shown that the efficacy of ARTs using fresh embryos is not significantly reduced (Ragni et al, 2005). Furthermore, these results were obtained in a retrospective fashion and, probably, influenced by several selection biases.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent multicentre survey (Ragni et al, 2005), the clinical impact of these limitations was evaluated, showing that the new legislation has induced only a small change in the success rate of ARTs using fresh embryos. These data are encouraging, even if altered by several biases due to the retrospective design of the study.…”

Section: Introductionmentioning

confidence: 99%

Clinical use of the perifollicular vascularity assessment in IVF cycles: a pilot study

Palomba¹,

Russo²,

Falbo³

et al. 2005

Human Reproduction

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BACKGROUND:In Italy, a recent law has imposed a ban on the fertilization of more than three oocytes at one time, and all resulting embryos produced must be transferred simultaneously. The aim of the present controlled study was to assess the clinical feasibility and efficacy of the perifollicular vascularity assessment for oocyte selection in IVF cycles. METHODS: Fifty-four young primary infertile non-obese women (27 cases and 27 age-and BMI-matched controls) underwent IVF cycles. The choice of the oocytes to fertilize was performed according to perifollicular vascularization in the experimental group, whereas in the control group, the standard morphologic criteria alone were used. The dose of gonadotrophins used, the dominant follicles obtained, the duration of the ovarian stimulation, the number of oocytes retrieved, the number/quality of oocytes fertilized and of cleaved embryos, cycle cancellation, implantation, clinical pregnancy, ongoing pregnancy, multiple pregnancies and ovarian hyperstimulation syndrome rates were assessed in each group. RESULTS: The assessment of perifollicular vascularity was feasible in 88.9% of cases. No difference between groups was detected in any parameter evaluated. CONCLUSION: Power Doppler assessment of perifollicular vascularity seems to have no clinical utility for oocyte selection in IVF cycles for young infertile women.

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“…However, it is generally acknowledged that the reliability of current methods for predicting embryo viability requires further improvement which may arise by combining the evaluation of different parameters at successive time points. Moreover, in some countries, not all retrieved oocytes can be fertilized due to legal limitations (Ragni et al 2005). In such situations, predicting embryo quality is even more challenging because the time when the predictive evaluation can be performed is limited to the interval between oocyte retrieval and fertilization.…”

Section: Introductionmentioning

confidence: 99%

Association between human oocyte developmental competence and expression levels of some cumulus genes

Cillo¹,

Brevini²,

Abednatanzi³

et al. 2007

Reproduction

172

130

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At present, oocyte selection is mainly based upon morphological criteria but it is generally acknowledged that its reliability requires further improvement. The aim of this study was to determine whether transcript levels in cumulus cells can provide a useful marker of oocyte developmental competence in vitro. A retrospective study was performed on cumulus cells isolated from 90 oocytes retrieved from 45 patients. Upon fertilization, 35 oocytes originated good-quality embryos and 36 developed into poor-quality embryos, whereas 19 failed to be fertilized. Semi-quantitative measurement of hyaluronic acid synthase 2 (HAS2), gremlin1 (GREM1), and pentraxin 3 (PTX3) mRNAs was performed and data for all genes were obtained from all the samples. Cumulus cells isolated from oocytes that originated high-quality embryos on day 3 of culture had HAS2 and GREM1 transcript levels higher than those detected in cells from oocytes that did not fertilize or developed into poor-quality embryos. No differences were observed in PTX3 levels. Results indicate that the measurement of HAS2 and GREM1 levels in cumulus cells would reliably complement the morphological evaluation providing a useful tool for selecting oocytes with greater chances to be fertilized and develop in vitro.

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The 2004 Italian legislation regulating assisted reproduction technology: a multicentre survey on the results of IVF cycles

Abstract: The rate of success of IVF-ICSI cycles using fresh embryos is not significantly influenced by the new legislation while the prohibition to freeze embryos seems to result in a more relevant impact.

Cited by 62 publications

References 16 publications

The Italian Experience of A Restrictive IVF Law: A Review

The Italian Experience of A Restrictive IVF Law: A Review

Clinical use of the perifollicular vascularity assessment in IVF cycles: a pilot study

Association between human oocyte developmental competence and expression levels of some cumulus genes

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