Medically assisted reproduction MAP: from level I to level II techniques. The complete guide to assisted fertilization in Italy
Medically assisted reproduction MAP
Louise Brown was born in 1978 in the United Kingdom and her birth was an event of global significance because she was the first child born thanks to in vitro fertilization. They have passed 40 years from that first fundamental step and since then millions of couples around the world have been able to fulfill their dream of becoming parents thanks to Medically Assisted Procreation (MAP) increasingly sophisticated and precise.
In this article
What is it?
There Medically Assisted Reproduction (MAP) is a highly specialized branch of medicine aimed at helping couples who are trying to have a child without being able to satisfy this desire with the help of hospital care.
The different PMA procedures include:
- homologous insemination
- in vitro fertilization and embryo transfer
- intratubal transfer of gametes
- intratubal transfer of the zygotes
- intra-tubal embryo transfer
- cryopreservation of gametes and embryos.
Medically Assisted Procreation Video
In this video, Dr. Andrea Borini, clinical manager of the national network 9PuntoBaby, takes stock of the different techniques of MAP, from level I to level II, and explains how many attempts can be made.
Assisted fertilization Video
In this video, Dr. Andrea Borini, clinical manager of the national network 9PuntoBaby, explains what the various are techniques of assisted fertilization and in which cases couples can turn to specialized centers
Italy is one of the European countries with the largest number of centers dedicated to MAP, these are both private, affiliated and public structures. Since 2017, the services for medically assisted procreation are included in the LEA, i.e. in the Essential Levels of Assistance, however, there are still profound differences in the quality standards of treatments in the various Regions and the waiting lists can be years long: this pushes many couples to turn to private centers, where the cost of the same level II MAP techniques can vary from three thousand to five thousand euros.
Due to costs and bureaucratic limitations, the procreative tourism it is still very flourishing: according to data from the Procreative Tourism Observatory, about 10 thousand couples a year go to foreign clinics.
According to the guidelines, tests can be made to understand if there are real impediments to conception after 12 months of unsuccessful attempts, while this limit drops to 6 months in the case of women over the age of 35 or in the presence of risk factors such as pathologies of the reproductive system or previous operations on the pelvic organs.
PMA techniques are classified into techniques of I, II and III level depending on their complexity and degree of invasiveness. There law establishes that it is necessary to start from the least invasive techniques, therefore those of the first level, to then move on to the following ones. All this only after carefully assessing the couple’s health conditions and the causes of infertility
The Minister of Health outlines the guidelines that contain the indication of the procedures and techniques of MAP; these guidelines are updated at least every three years.
What the law says
In Italy, access to Medically Assisted Procreation techniques is regulated by the law 19 February 2004, n. 40 called “Rules on medically assisted procreation“. The law establishes that to solve problems of sterility or infertility, the use of medically assisted procreation is allowed only when there are no other effective therapeutic methods to solve the causes of sterility or infertility. Over the years the initial implementation of the law it has been profoundly modified, also following sentences issued by the Courts.
L’latest update of the PMA Guidelines in Italy it is available on the website of the Ministry of Health