«Ftest tube fair», in which «the birth rate is commodified»: the controversies around the free demonstration for inform about in vitro fertilization treatments Wish for a baby, scheduled in Milan on 20 and 21 May 2023, they show no sign of turning off. And this despite Five Senses Media Ltd, which organizes the event (already staged in Berlin, Cologne, Paris and Munich), has ensured that no, during the two days, there will be no references to surrogacy, surrogate uterus or pregnancy for others. That is, the most controversial topics that violate the rules on PMA in Italy.
In our country the medically assisted procreation it has been possible since 2004. Pma means all the techniques designed to help couples with fertility problems to become parents. They are distinguished by the origin of the biological material (fertilization homologous if it comes from the couple ed heterologous if it comes from a donor, permitted in Italy since 2014) and the complexity of the procedure. The simplest ones, such as intrauterine insemination, are called di first levelwhile the more sophisticated ones, such as in vitro fertilization or intratubal transfer of gametes, are of second and third level.
Against Wish for a baby have been exhibited by Ai.Bi., Friends of the Children and other pro-life associations, and a text against the fair was also presented and approved in the City Council.
Pma in Italy. The private (foreign) clinic is no longer an obvious choice
We will see if, as happened last year, the demonstration will be blocked or will finally be able to go on stage. Regardless of the fact that there will be no mention of a rented uterus, «the event is certainly one showcase for foreign Pma centers trying to recover their market», is the opinion of Antoninus Wilhelmpresident for the gynecological area from Italian Society of Human Reproduction (Siru). Until the approval of heterologous fertilization in our country, in 2014, trips to Spain, but also to the Czech Republic and Ukraine, to look for a child were on the agenda: they were the only solution for dozens of thousands of couples who, for 10 years, have spent between 7 and 10 thousand euros for assistance abroad. But even after 2014 the habit has not been lost.
Pma path in Italy, how it works
Many couples assume that in Spain, for example, where Pma has been done for 40 years, they work better. Others trust success rates above 90% vaunted and unrealistic. They let themselves be lulled by expressions like “baby in arms pregnancy guarantee” (it is also the title of a seminar of Wish for a baby).
But there are also other reasons that lead to packing: for example i age limits or the number of cycles funded by the public health service. There are long ones waiting lists (and the longer you wait, the more the quality of sperm and ova decreases, along with the possibility of becoming parents). And sometimes the desire to do not inform anyone of the path that it was decided to take, given the stigma that still weighs on children “born” in test tubes.
Second a recent studythe most popular destinations for i motherhood trips they are Spain, the Czech Republic, Denmark and Belgium. In 2019, for example, Spanish fertility clinics carried out 18,457 treatment cycles for people from abroad, mostly from France and Italy.
Healthcare tourism: if looking for a child is a journey
But there are also incredible rates of mobility within the Italian borders. For matters of costs (in Lombardy the ticket for a Pma course costs 37 euros, in Tuscany 500, in Sicily 2,774) and age limits to enter (from 46 in Piedmont to 41 in Umbria). According to Guglielmino, due to these differences, assisted procreation is one of the treatments carried out most often in a regional health system different from that of residence: «The internal migration rate today it is almost 30 percent. I don’t think there are other pathologies that have such a high interregional migration rate. It’s ridiculous”.
But they lack in Italy i gamete donors (sperms and oocytes). «In the face of those who speak, for Italy, of ethnic substitution, due to immigration, the truth is that a genetic replacement», William ironically: «96% of the gametes we use for Pma are imported».
The revolution: access to the Pma up to 46 years of age with the NHS
What is looming on the horizon is a great revolution that could contribute to normalize assisted reproduction, as well as egg and sperm donation. The Pma has in fact been included in the Essential Levels of Assistance (Leah): “This means that from 1 January 2024 it will be possible to pursue the search for a child with the National Health System, each in their own region, in contact with their general practitioner and with consultants distributed throughout the area. Access to the procedures, 6 homologous fertilization treatments and 6 heterologous fertilization treatments, will be possible for women up to 46 years of age» explains Guglielmino.
Experts expect a real boom in requests from Pma, therefore there will be enormous pressure on Italian public and private centers with which they have an agreement. “The data says that about 15% of couples he needs it. And soon they will finally be able to do it at Km 0».
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