Over 217 thousand children have been born thanks to medically assisted procreation (PMA) techniques in 20 years, i.e. since the approval of law 40/2004 which regulates MAP. The number of treatments carried out each year has doubled, as have pregnancy rates, and procedures using cryopreserved embryos have also increased sharply. These are some of the data collected by the National Registry of Medically Assisted Procreation, established by law 40 at the Istituto Superiore di Sanità and which began its activity in 2005. The data are released in view of the twentieth anniversary of the approval of the law , which occurs on February 19th.
In the period 2005-2022, the Higher Institute of Health notes, MAP activity increased almost twice, from 63,585 treatments in 2005 to 109,755 in 2022, and the percentage of children born alive in the general population which in 2005 was of 1.22% in 2022 it reached 4.25%. The registry obtained information relating to 217,275 children born alive (such as the population of Messina and/or Padua) following the application of Pma techniques.
ART procedures involving the use of cryopreserved embryos increased from 1,338 in 2005, equal to 3.6% of procedures, to 29,890 in 2022, equal to 31.1%, similar to the European average value of 2019 (latest data available) which was 31.2%. The relative pregnancy rate per 100 transfers performed increased from 16.3% in 2005 to 32.9% in 2022. Furthermore, ART techniques using donated gametes increased from 246 cycles in 2014, equal to 0.3 %, to 15,131 cycles in 2022, equal to 13.8%.
The age of women is growing and 34% are over 40
The average age of women who undergo medically assisted procreation (PMA) cycles is growing in Italy: it went from 34 years in 2005 to 37 years in 2022 (in Europe in 2019 it was 35 years). The share of women over 40, which was 20.7% in 2005, reached 33.9% in 2022 (in Europe in 2019 it was 21.9%). This emerges from the data collected by the National Register of Medically Assisted Procreation, established by law 40/2004 which regulates Pma, at the Istituto Superiore di Sanità.
The average number of embryos transferred to the uterus, the data show, went from 2.3 in 2005 to 1.3 in 2022. The percentage of multiple births fell from 23.2% in 2005 to 5.9% in 2022.
The National MAP Registry is established within the Istituto Superiore di Sanità and its responsibility has been entrusted to Giulia Scaravelli, a gynecologist and pharmacologist who coordinates a multidisciplinary working group with skills in epidemiology, statistics, IT, communication and psychology. The staff, in addition to managing the data collection of the Registry, dedicates part of its work to the creation and promotion of research projects on the pathological, psychological, environmental and social causes of infertility, as well as techniques for cryopreservation of gametes and preservation of fertility in cancer patients and women at risk of early loss of reproductive function.
Assisted reproduction centres, ‘The PMA is a tool against the birth rate decline. Greater awareness and knowledge needed
“More awareness and knowledge of medically assisted procreation (PMA) techniques is also needed by citizens as a possible and further tool to curb the birth rate in Italy”. This is the appeal of the Genera centers for the diagnosis and treatment of infertility on the occasion of the twentieth anniversary of law 40/2004 which regulates ART in Italy.
“From 2004 to today, the flow of newborns has progressively increased, not without the difficulties linked to the prohibitions that once existed precisely on the basis of law 40. Prohibitions, such as that of resorting to heterologous fertilization, or of being able to attempt PMA in case of fertile couples but carriers of genetic diseases, which then fell through thanks to the intervention of the Constitutional Court and which today no longer constitute an obstacle for Italian couples wishing to have a child”, explains Filippo Maria Ubaldi, medical director of the network of 8 clinics specializing in reproductive medicine.
“In 2004, Pma did not offer the possibilities and chances of success that exist today – adds Laura Rienzi, scientific director of Genera – the technology has evolved a lot both at a clinical level and within embryology laboratories. Cryopreservation of gametes, pre-implantation genetic testing on embryos, personalized hormonal stimulation protocols. These are all achievements that the most advanced centers have achieved in the last 20 years, allowing them to optimize the chances of PMA success. Today we are faced with challenges such as the use of artificial intelligence, big data, genetic tests for the study and prevention of infertility: all frontiers that we are exploring. What is certain is that today in Italy the offer of treatments is cutting-edge and has nothing to envy of that of other European countries. Currently, access to these techniques is continually improving, but it could be expanded by intervening on citizen awareness, as well as naturally increasing the offer of services throughout the national territory” . An “important goal to achieve, considering that the Pma – concludes Renzi – could make an even more significant contribution to the continuous decline in births that we have been witnessing for years in Italy”.
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