The Latest Technology Of Ova Freezing

16.03.2011

The latest issue in IVF is whether we can avoid freezing of embryos at all. There is the latest technology which allows for the freezing of ova; fertilising them only when they are sure to be implanted
Dr Pierre Schembri Wismayer gave a very good and important presentation in front of the Parliamentary Committee for Social Affairs, which still has to have at least another session for the committee to put relevant questions.
In the presentation, Dr Schembri Wismayer explained that the freezing of ova is a valid alternative and related some of the successes abroad, quoting references and explaining some of the experiments. There are downsides. He pointed out, for example, that using the freezing of ova method changes the texture of the outer lining of the ovum and therefore one cannot fertilise these eggs in a straightforward manner as is often used in IVF, where ova and sperm are mixed together allowing a random selection of sperm. Rather, one has to use intracytoplasmic injection of sperm (ICSI). Here one has to inject the sperm directly into the ovum. Once an egg is frozen, the sperm have to be helped to fertilise the ovum.
ICSI however is already used, for not all cases of IVF have been using a mere ‘mixture’ of sperm and ova. Often the problem with the couple is either a low sperm count or a low motility and therefore need assistance to fertilise the egg – by injecting it directly into the cytoplasm of the ovum. Ironically this is the video that is often used in programmes on IVF.
This presentation has its supporters; including myself, who would wish not to see any freezing of embryos. I have already alluded in this column that should freezing be unavoidable the government should make a serious decision to show that it is not in either the embryos’, and neither in the State’s interest (as the ultimate custodian of life) that embryos remain frozen.
In this scenario I am simply accepting the normative ethics which are generally reflected in the population and on which parliament has to vote. Should freezing of embryos be allowed, then there should be a stipulated time, I had written, within which the couple have to use them and give them a chance at continuing their life. If in any way the couple defaults, the government should take custodianship and donate them. But this is not easy at law and one would have to legislate in favour of relinquishing what may ultimately be fundamental rights and freedoms. Whether it is possible is a legal conundrum. Although at the time of writing it was dismissed, the discussions in the corridors of the Palace following this sitting showed that it must be considered.
But freezing of ova is not that simple either. There are three considerations. The first is that it is not as yet a technology which is as widely available and some expert gynaecologists in the field say that the technology is still in its early stages. The presentation acknowledged this as well. The second therefore follows this; should we wait until it is a viable option? Something which inevitably will occur but which may not be as much on the doorstep as we would wish it to be. Thirdly there is the question of cost, for one has to use ICSI each and every time – something requiring more expertise and costs. Cost in fact can be considerably higher. But to this third consideration we must be willing to walk the extra mile if we are adamant on not freezing embryos and still wish to help infertile couples. Where life is concerned, perhaps cost should not be an issue – but it may have weight on the amount you can treat and we do not really want to see waiting lists here as well.
AZAD also held a public debate on the issue. Unfortunately an untimely death in my practice kept me away and I could not contribute again the options that the government has, which I therefore sought to repeat here. The intervention which made much sense was that there are various points where philosophers define when life begins morally; but our choice is obvious and has to reflect our values, which is why we choose not to freeze embryos. Advising government to take responsibility or custody is not in any way condoning freezing but it is putting a strong limit on quantity of numbers and time and protecting their life. In any case the time will come when we can freeze ova. The question is whether it is readily available to us now and whether we can afford it. These are certainly not prohibitive realities.

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