This page details the parliamentary briefing provided by the RCOG regarding the Human Fetilisation and Embryology Bill. This briefing document was prepared in April 2008.
The Human Fertilisation and Embryology Bill is about to be debated at the Second Reading in the House of Commons, and the RCOG is aware there are several outstanding subjects within the Bill which MPs would like more information about. This document sets out the RCOG’s position on the various issues identified as relevant to the medical specialty.
The Bill updates and formalises current legislation and the proposed amendments will ensure that the Act is fit for purpose, in light of medical, legal and social changes that have occurred since 1990.
The RCOG believes that the Bill, in its present form, is good and provides scientists and doctors with a regulatory framework from which to ensure that treatment and research in assisted reproduction are appropriately licensed and managed. The prohibitions that are in place within the Bill will guarantee that research is strictly controlled and accredited by the Human Fertilisation and Embryology Authority (HFEA).
The implications for women are that they will be offered the best quality of care that is available to them on the NHS. Patients affected by certain genetic and/or hereditary diseases have the reassurance that scientists are conducting crucial research in the hope of finding cures for their diseases. Based on these reasons, the RCOG supports the provisions in the Bill.
Below is a list of what we see as the main issues from the perspective of the practice of obstetrics and gynaecology and women’s health care.
Human ad-mixed or hybrid embryos
The RCOG believes that scientists should be granted licences to carry out important stem cell research derived from human ad-mixed embryos. Donated human eggs for research are in short supply. The process of egg-harvesting is potentially fatal in a minority of women who develop ovarian hyperstimulation syndrome (OHSS). Given these reasons, the RCOG agrees with the use of human ad-mixed embryos in stem cell research. Recent scientific developments have demonstrated that stem cell lines can now be derived from cord blood and induced pluripotent stem cells (iPS). The RCOG believes that all three methods, including embryonic stem cells, are needed to ensure that the UK remains a world leader in stem cell research. These human ad-mixed embryos will only be used for research. They will not be implanted into humans and will be destroyed after 14 days as set out in the Bill [‘Prohibitions in connection with genetic material not of human origin’, 4A(1) – (3), pp. 3 – 4].
Preimplantation genetic diagnosis (PGD)
In IVF treatment, the best quality embryos are selected for implantation so that the woman has a better chance of a successful pregnancy. PGD is a form of embryo screening that detects specific genetic anomalies in embryos, where there is a family history of an inherited disease. Only healthy embryos that are free of these genetic disorders are then implanted during IVF.
The RCOG believes that in special cases, as set out in the Bill, PGD should be allowed in fertility treatment to establish whether the embryo has an abnormality that will result in the child developing a serious physical or mental illness. [Schedule 2: Activities that may be licensed under the 1990 Act, ‘Embryo testing and sex selection’, 3.1(a) – (c), 3. 2, 3. 3, pp. 55 – 56]
Need for a father
The RCOG recognises that a stable family environment is one where the single parent or both parents are able to provide for the child. However, the RCOG believes that it is not the responsibility of doctors providing fertility treatment to decide if a woman or the couple seeking IVF treatment are capable of addressing the future needs of the child. Guidance is required from Parliament on this issue. It is important to ensure that the revised Human Fertilisation and Embryology Act is compliant with current equality and diversity legislation. This means that single women or lesbian couples seeking IVF treatment are regarded in the same manner as heterosexual couples seeking IVF treatment.
The abortion time limit
The time limit should stay at 24 weeks. Only 2% of all abortions carried out each year occur between 20 and 24 weeks and there is no evidence that lowering the time limit will reduce the numbers of abortions.
There is the argument that the time limit should be lowered because premature babies have a better chance of survival. Recent media coverage of the national research study, EPICure 2, which investigated survival data for all babies born below 26 weeks during 2006, reported that there is no significant improvement in the neonatal survival of premature babies born below 24 weeks.
Lowering the time limit will also mean that women seeking abortions for fetal abnormality after the 20 week scan, or those with a late confirmation of an unwanted pregnancy, will be affected.
Good scientific evidence and expert opinion from the British Medical Association, the Royal College of Nursing and the RCOG state that the time limit should remain at 24 weeks.
If the desire is to lower the number of abortions, then the solution must be to provide better sex education and incremental investment in contraception care to men and women.
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