“Whoever criticises IVF and assisted reproductive procedures in Malta must stop to consider how they would feel if they were in the shoes of those who want to have children but can’t,” said Ernest Skorfna, a father of two children born through IVF, at a press conference held at St James Hospital yesterday.
“Similar comments hurt people especially in a country that is full of children and wagging tongues,” said Josie Muscat, head of St James’ Hospital. He said he called the press conference to clear any doubts or allegations made recently over the past few months since discussions on whether to legislate assisted reproduction have started, and especially because of last week’s programme of Bondiplus. “We have nothing to hide here and we are not afraid of what people are saying.”
“What right does the Children’s Commissioner have to stop me from having children like she does?” said John Ghirxi, father of triplets born through IVF. “When I heard what she said about IVF children having a higher risk of cancer, my wife and I panicked and we called Dr Muscat who reassured us that this was not so.”
Dr Muscat estimated that over 300 children have been born by means of assisted reproduction techniques in Malta over the past 18 years, and around 200 children were born assisted by techniques offered at St James. “Around 4,300 couples came to St James Hospital during the last 18 years, and only a very small percentage needed IVF.”
All the fertilised eggs which develop into embryos are transferred back into the patient. The patients are warned beforehand that all the fertilised eggs will be transferred to the mother. “When a couple request for just two embryos to be transferred we simply fertilise two eggs, but they know that we will not throw away any embryos,” he said.
Dr Muscat explained that 70 to 75 per cent of all assisted procedures result in non-pregnancy as the process is an extremely delicate one and subject to various factors and conditions. On average, 60 to 70 patients seek assisted reproductive procedures and only 20 to 30 per cent of these are successful.
“It was said that there are no fertility clinics in Malta, but this is not true. St James offers assisted reproduction and therefore is a fertility clinic,” he said.
He explained that many automatically assumed that IVF is the only method used by infertile couples. “IVF is used when the woman has infertility problems, and ICSI when the man has them. Usually, 30 per cent of the problems lie with the woman, 30 per cent with the man, 30 per cent with both and 10 per cent are unknown.”
Referring to comments made by Children’s Commissioner Sonia Camilleri that IVF does not cure infertility, Dr Muscat said, “IVF does cure infertility. Usually, it’s the first successful pregnancy that is always the problem. Once it takes place, then usually the second pregnancy will occur naturally.”
He also pointed out that counselling services are available at St James. “Although it is rarely used, we have a counsellor available for couples who wish to speak to her. However, all the counselling and advice is given by the doctors who are involved in the process.”
“When we started IVF at St James, the doctors explained everything in detail, answered all the queries and cleared any doubts we had,” Mr Skorfna, said.
Dr Muscat said St James Hospital is very much in favour of a regulated environment. “However, in the absence of such regulations, St James continues to provide patient-focused care within a scientific, moral and ethical framework.”
This includes a conscious decision not to freeze embryos. “We have suffered because of this decision, as some couples decide to go abroad, or gynaecologists recommend their patients go to foreign clinics because freezing is available,” he added.
“If the government decides to allow the freezing of embryos, then we will consider the option. However, people must not be mistaken into thinking that couples can be forced to use all their embryos,” he said.
“I still believe Mrs Camilleri should be asked to resign if she made those statements in her role as Children’s Commissioner.
“The person who said on television that babies are dying like flies at hospital because of multiple births, is totally irresponsible and this statement should not have been made by someone who considers himself a doctor,” said Dr Muscat (referring to the comment “it-trabi qed imutu bhad-dubbien” made by Dr Paul Soler, paediatrician and head of the special care baby unit on last week’s programme of Bondiplus). “The allegations that assisted reproductive procedure babies end up in the special care baby unit (SCBU) are totally unfounded and categorically false. The Minister responsible should open an inquiry and investigate these allegations.
“During the past 14 years we have been carrying out IVF at St James, e we only had a case of quadruplets once and the SCBU didn’t even see them as two died immediately after they were born, one soon after and one lived,” said Dr Muscat. Through IVF and ICSI procedures the number of births are controlled.
“The quadruplets this person (still referring to Dr Soler) was talking about did not come from St James and not even from St Luke’s but probably from other gynaecologists who were using a technique called controlled ovarian hyperstimulation (COHS) which stimulates the woman’s ovaries to produce more eggs using pills and/or injections,” he added.
Dr Muscat went on to say that allegations made on Bondiplus (by Dr Soler) that St James earns millions of Maltese liri through assisted reproductive procedures were totally unfounded. “I challenge him to prove that we are making a million liri a week through these procedures and I will personally write him a cheque of one million to spend on incubators at the SCBU,” he said.
He explained that an assisted reproductive procedure normally costs between Lm850 for IVF and Lm1,000 for ICSI, whereas abroad IVF costs between Lm1,500 and Lm2,000 and ICSI around Lm2,500 and Lm3,000 with a similar success rate.
The consultant in charge of the whole procedure, which takes from four to six weeks is entitled to 20 per cent – which adds up to a total of about Lm200 per patient, he explained.