Pandemic effect on assisted reproduction, births down by 20%
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The pandemic is also bringing drastic consequences on births with assisted procreation: the decline recorded in the Covid period is 20%, a situation that is worrying. From this comes an appeal to support PMA services as a tool to help the country emerge from the demographic winter, while reopening the chapter on the tariffs of the essential levels of assistance (Lea) relating to the sector, blocked by the last legislature. To launch it, to the new government led by Giorgia Meloni, is the Italian Society of Fertility and Sterility – Reproductive Medicine (Sifes-Mr), gathered for the annual congress in Rome from 10 to 12 November.
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Pma births dropped by 20%
As a result of the pandemic, notes the Sifes-Mr, the drop in births with Pma is 20% from 2019 to 2020. And it states: “Infertility is recognized by the World Health Organization (WHO) as a real pathology: it is defined as the absence of conception after 12 months of regular unprotected targeted sexual intercourse. In Italy it affects about 15-20% of couples “.
It must be said that last year, in Italy, for the first time there was a drop below 400,000 births, a sign of the heavy demographic decline that has been going on for some time: births in continuous decline (soon they will hit the negative record of 350,000 according to the ‘Istat) correspond to 800,000 deaths a year. On the other hand, the children who came into the world thanks to Pma were in constant growth until 2019, equal to 3% of all new borns (about 14,000).
The ministry report
According to the recent Report to Parliament signed by the Ministry of Health on Law 40 of 2004 on medically assisted procreation, from 2019 to 2020, as a result of the Covid pandemic, a decrease in the use of reproductive medicine was observed: the couples treated were dropped from over 78,000 to 65,000, the cycles performed went from 99,000 to 80,000 (-19%) and live-born children went from over 14.00 to 11,000 (-20%). One less contribution to the demographic decline that Italy has been witnessing for years.
The social uncertainty factor
“The great social uncertainty linked to this very delicate historical period is one of the reasons why couples in Italy are always looking for a later pregnancy – underlines Filippo Maria Ubaldi, President Sifes-Mr -. From 2010 to today, the average age at birth of Italian women has risen from 31.1 to over 33 years, and the age of women at the start of the search for a child has also been constant “.
Ubaldi points out that “it is precisely advanced maternal age that is the main cause of infertility”. Suggesting: “When the need is to seek a safer and faster pregnancy, because age advances and spontaneous attempts do not reach the desired results, the important role of Pma must be recognized, but above all the correct information on this must be disseminated. theme and ensure correct and extensive access to specialized centers throughout Italy “.
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The technical table
He also intervenes on the subject Luca Mencaglia, coordinator of the technical table for research and training in the prevention and treatment of infertility set up at the Ministry of Health and president of the Pma Foundation. “Italy is in the grip of a dramatic reduction in births and the contribution of the PMA could be much greater if more funds were dedicated to this discipline – Mencaglia highlighted at the congress -. hoc, which could analyze and solve the problems related to the world of assisted fertilization and in which we participated with enthusiasm, and despite the previous government having allocated 234 million euros for the pricing of the Lea (essential levels of assistance) introduced in 2017, the The tariff decree has remained stuck, as are the measures we had proposed to facilitate the donation of gametes in our country as well “.
Here’s what it takes
So what is needed? According to Mencaglia “decisive action is needed to reverse the course and meet the needs of couples with infertility problems, who are still forced to move to other regions or abroad to try to reach the goal of having a child”.
While, if there is no intervention by the new government, for Ubaldi “these couples will continue to be discriminated against on the basis of where they live, and the structures will continue to provide patchy services, with all the resulting inequalities: an all-Italian myopia “.
Performance-related rates
In the meantime, the ministerial table has worked to attribute a tariff to each Pma service provided for in the Lea. “We arrived at the definition of reasonable costs for even very advanced services, arranging for the introduction in Lea of new services with relative rates so far completely ignored, such as preimplantation genetic diagnosis and the freezing and thawing of gametes and embryos – explains Mencaglia -. The goal is for everyone to obtain a homogeneous and functional system also for the resumption of births in Italy. At the moment, however, the hope that something could change has vanished “.
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The themes of the congress
All this is being discussed at the Sifes congress, a scientific society on the official list of the Ministry of Health. In addition to socio-political issues, medical-scientific topics are being explored. Here are some of them: “Do the diagnostic tests’ accessory to the PMA work?”; “Pregnancy after assisted fertilization: multiple, with complications, with a look at the health of the children born from these techniques”; “Genetics and artificial intelligence in assisted reproduction”; “New frontiers in ovarian stimulation”; “Factors impacting reproductive health: from inflammatory and / or autoimmune diseases to nutrition”.
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