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Doctors' dilemma over GIFT and the government's bill

作者:贺馔    发布时间:2019-02-26 05:02:18    

By GAIL VINE A ROW has broken out in Britain over whether GIFT, the controversial treatment for infertility, is already covered by the Human Fertilisation and Embryology Bill – and if it is not, whether it should be. Britain’s medical establishment believes that if included, such regulation would interfere with doctors’ rights to treat patients as they see fit. Other doctors disagree, saying that the technique must be regulated. The bill is now at committee stage in the House of Commons. Just to make sure, Jo Richardson, the Labour MP, has tabled an amendment that would ensure that GIFT (gamete intrafallopian transfer) comes within the scope of the licensing authority that will be set up to regulate IVF (in vitro fertilisation). Some scientists now say that the wording of the bill as it stands means that GIFT is already included. In GIFT, the egg and sperm are passed directly into the fallopian tube, where fertilisation takes place. In IVF, the egg is fertilised in the laboratory and then replaced in the woman. Both procedures involve treatment with drugs and an operation to remove eggs, and both carry the risk of multiple pregnancies. A straw poll of leading British practitioners of IVF and GIFT conducted by New Scientist were five in favour of including GIFT in the bill and two against. But the Royal College of Obstetricians and Gynaecologists opposes the regulation of GIFT by the licensing authority, claiming that it would encroach on the freedom of clinical practice. The Medical Research Council says that GIFT is already implicitly covered by the bill. As it stands, the bill covers procedures that involve ‘an egg in the process of fertilisation’. Robert Key, a spokesman for the MRC and a Conservative MP, told the Commons standing committee that it would be impossible to perform GIFT, and so put egg and sperm together in a catheter ready for transfer to a woman’s fallopian tube, without initiating fertilisation. The sperm would very rapidly bind to the egg’s outer coat, the zona pellucida. Key concluded: ‘It would be inappropriate to amend the bill as GIFT is already covered.’ But Key also maintained that the government would be right to resist the amendment because, he said, ‘it would set a precedent’ that ‘would restrict further development’ of medical practice. Ann Widdecombe, a Conservative MP who is sitting on the committee, deplored this reasoning. ‘Is GIFT already covered by the bill? If it is, what is the harm in having it made explicit?’ she asked. David Wilshire, a Conservative MP, said: ‘Heaven preserve us, and women at risk, from court cases to decide whether legislation covers GIFT. We must remove all doubt.’ Richardson argued strongly for the amendment: ‘Unless GIFT is brought within the control of the licensing authority, there is nothing to prevent some doctors and clinics improving the success rate of pregnancies simply by increasing the number of eggs that they put back into women, rather than by improving the skills in doing so.’ Last week, the MRC released the results of its survey of babies born through IVF or GIFT. Such babies were more likely than those conventionally conceived to be born premature and underweight,

 

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