Dr. Josie Muscat defends IVF - 14/6/2005

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Dr Josie Muscat, who has been running a fertility clinic for the past 18 years, said yesterday that statements that were being made about in vitro fertilisation (IVF) reflected ignorance on the subject, since they were unfounded and false.

Addressing a news conference at St James Capua Hospital, Sliema, he said that statements made in newspaper articles and television programmes were very damaging to couples who desperately wanted children but could not have them naturally and had sought methods of assisted procreation, not necessarily IVF.

Dr Muscat said that IVF was only offered by his clinic in Malta, and this had been the case for the past 14 years. The clinic also offered Intra cytoplasmic sperm injection (ICSI) and PESA and TESA (percutaneous sperm aspiration and testicular sperm aspiration).

In all these procedures, the aim was to get the egg and sperm in close proximity to allow fertilisation to take place.

He said that, once a couple having problems with conception went to his clinic, the first step was to try to identify the problem to solve it in the most suitable way. It was only when all possibilities were exhausted that the clinic proceed with IVF, ICSI, PESA or TESA.

In 30 per cent of the cases, the problem was with the man; in another 30 per cent, with the woman; in 30 per cent, it was with both; and in 10 per cent of the cases, the cause of the problem was unknown.

Referring to a statement that there were natural methods, which could be adopted for a woman to get pregnant, he said that he could not see how, for example, a woman with blocked Fallopian tubes could get pregnant naturally.

Pills and injections would rectify the problem of a woman who was not ovulating but IVF was needed when tubes were blocked.

IVF was generally only used as a last resort, he said. It was used as a first resort only when the problem was known and there were no alternatives.

Dr Muscat said that, although the services of a counsellor trained at Lister Hospital in the UK were available at his clinic, most couples opted not to take counselling.

He said that those who said that the way IVF was done in Malta was frightening did not know what they were saying and their statement was an insult. These people should explain exactly what they found to be frightening.

He said that, although there was no regulating law in Malta, his clinic, which was the only one to offer the services, had drawn up its own standards and limits.

The clinic, for example, did not freeze embryos, opting to fertilise only a maximum of four ova and implanting them all. This meant that no embryos were wasting away or dying.

The clinic, Dr Muscat said, had suffered from this decision as there had been prospective clients who opted to go abroad because of this.

Therefore, those who were saying that embryos were being thrown away were saying so maliciously or because they did not know what they were saying.

Abroad, he said, all ova were fertilised and the extra ones were frozen or thrown away.

He said that the average success rate of IVF, resulting in a take-home baby, was 25 per cent. It was a very traumatic experience and those who spoke without knowing what they were saying did a lot of damage.

The clinic also refused to fertilise eggs with donated sperm (not from the husband) and at this very moment, Dr Muscat said, there was a couple in Cyprus and another in Russia to receive IVF treatment through donor sperm. One of the overseas clinics had also sent the couple pictures to choose the sperm donor.

He also pointed out that not all couples seeking IVF went to his clinic; many gynaecologists still preferred to send their patients abroad, despite the substantially higher costs.

Dr Muscat said he was not against regulation. What he would not like was to see the creation of a commission formed of "incompetent" persons who may try to block the treatment "in a bid to show how much they know".

He pointed out that in the 14 years he has been carrying out IVF, he only had one instance of quadruplets and about six instances of triplets.

Dr Muscat said allegations that assisted reproduction clinics - there is only St James' in Malta - earned millions of liri through such procedures were also totally unfounded.

IVF in Malta cost Lm850 and ICSI Lm1,000, he said. Only Lm200 went for the doctor; the remainder were used to cover costs. Abroad, IVF cost between Lm1,500 and Lm2,000 and between Lm2,500 and Lm3,000 for ICSI. The success rates were the same. Dr Muscat said that another irresponsible statement made - by a person in the medical profession - was that babies in Malta were dying like flies. The person who said this should not call himself a doctor and if this were the case he was calling on the government for an investigation since this was a very serious accusation.

Two couples who had children through IVF - Tereza and Ernest Scorfna and John and Josette Ghirxi, said that IVF had been their only hope of making their dream of having a baby come true.

Mrs Scorfna said that, had it not been for IVF, it would not have been possible for her to conceive since her tubes had been removed.

Mrs Ghirxi, on the other hand, had her left tube removed after a natural pregnancy where the baby had been growing in this tube. In another two natural pregnancies, she again lost the babies when they grew in the remaining tube and doctors had advised her to take a break from trying for a child.

The Ghirxi family tried IVF in Australia twice but were unsuccessful and had one last shot at St James' some time after their return to Malta. Triplets were born as a result of that intervention.

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