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Assisted procreation, 217 thousand children born in Italy in twenty years

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Assisted procreation, 217 thousand children born in Italy in twenty years

Just one number is enough – provided by the Higher Institute of Health, which has a national register of medically assisted procreation, in operation since 2005 – to understand how disruptive MAP, medically assisted procreation, has been in our country. Because thanks to different assisted fertilization techniques, in 20 years, since the approval of law 40 (the twentieth anniversary falls on 19 February, but it came into force on 10 March 2004) 217 ​​thousand children have been born. Not a very small town.

When assisted procreation fails: the reasons in the black box by our correspondent Elvira Naselli 27 June 2023 In many cases some of these children were born despite law 40, which was created by placing restrictive limits, such as the ban on fertile couples but carriers of genetic diseases to access techniques to select healthy embryos. Or the ban on heterologous fertilization, which involves the donation of eggs and sperm. Or even the ban on cryopreserving gametes. All bans eliminated thanks to court rulings and appeals from couples and patient associations but which over the years has led many Italian couples abroad for treatments, a trend for which the not very beautiful term “procreative tourism” was coined. Freezing eggs to become a mother later: but how many succeed? by our correspondent Elvira Naselli 27 June 2023

But let’s get to the ISS data, because the numbers tell better than anything what has happened in these twenty years. From 63,585 treatments in 2005 we reached 109,755 in 2022. And while in 2005 the percentage of children born alive in the general population was 1.22%, in 2022 it reached 4.25%. This is also due to the increased percentage of success of the techniques, thanks also to increasingly advanced laboratories and an improvement and optimization of the procedures: the pregnancy rate for every 100 transfers performed has increased from 16.3% in 2005 to 32.9% in 2022. Obviously, success depends on many factors, primarily the age of the woman, which affects both the quality of the oocytes, their quantity and also the implantation of the embryo and the completion of the pregnancy. And the age of women is growing, also because probably a few anecdotal cases of pregnancies at 50 have conveyed the message that you can always have a chance of becoming a mother.

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The age of women

But here are the numbers: the average age of women who undergo assisted reproduction cycles has gone from 34 in 2005 to 37 in 2022 (in Europe in 2019 it was 35). Those over 40, who were 20.7% in 2005, increased to 33.9% in 2022 (in Europe in 2019 they were 21.9%). Fortunately – and as underlined for years by Eshre, the European society that deals with embryology and human reproduction – fewer twins are born: the percentage of multiple births has fallen from 23.2% in 2005 to 5.9% in 2022. The implantation of multiple embryos, which was a prelude to twin births, is now even considered almost a failure: the goal is to give birth to a child and no more, for medical reasons linked to the health of the mother and the fetus.

Heterologous

Pma techniques using donated gametes – what is called heterologous fertilization – increased from 246 cycles in 2014, equal to 0.3%, to 15,131 cycles in 2022, equal to 13.8%. This is because our country has a poor donation culture and gametes are almost always imported from other countries.

The use of cryopreserved embryos is also growing: from 1,338 cases in 2005, equal to 3.6% of procedures, to almost 30 thousand (29,890) in 2022, equal to 31.1%, similar to the European average value of 2019 (latest data available) which was 31.2%.

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