title: Reiterative changes in the Italian regulation on IVF: the effect on PGD patients' reproductive decisions.
abstract: National legislations represent one of the main factors influencing access to assisted reproduction treatment. The Italian situation in the last decade is an example of how the treatment of patients for preimplantation genetic diagnosis (PGD) was more dependent on regulators than on medical choices. This report analysed how the changes in Italian regulation affected the number of PGD referrals to this study centre, as well as their decision to opt for cross-border reproductive care (CBRC). The analysis showed that during the period in which PGD was actually not performed because of the restriction imposed by the Italian law on IVF (from 24 February 2004 to 7 May 2009) there was a significant decrease in the number of referrals asking for PGD (2.5% of total referrals) compared with the previous years (3.3%; P < 0.025) and following years when PGD was legalized (5.1%; P < 0.001). The number of couples opting for CBRC had an opposite trend, reaching a maximum when PGD was banned from Italian centres (55 couples), whereas after the readmission of PGD, only eight couples went abroad for treatment. Concomitantly, since May 2009, the proportion of couples performing a PGD cycle in this centre has constantly increased.
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy. Electronic address: luca.gianaroli@sismer.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Gianaroli
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Crivello
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Stanghellini
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy.
authors.forename: Anna Pia
authors.initials: AP
authors.lastname: Ferraretti
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Tabanelli
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Magli
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D030342:Genetic Diseases, Inborn / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007558:Italy / Q000453:epidemiology; D057193:Medical Tourism / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data
keywords: Italian law on IVF; PGD; cross-border reproductive care; monogenic diseases; therapeutic abortion; translocations