DAILY NEWS

Italian minister in trouble

Calls for his resignation abound after stem cell transplant announcement

Politicians and scientists in Italy are calling for the resignation of health minister Girolamo Sirchia this week, over a contentious law on assisted reproduction.

The law, strongly supported by Sirchia, was approved by the Italian legislature last December. It has been branded "medieval" by female parliamentarians and gained worldwide condemnation by scientists.

The legislation bans any testing of embryos for research and experimental purposes, freezing embryos or embryo suppression, and forbids preimplantation diagnosis for preventing genetically transmitted diseases.

It also prohibits donor insemination, limits fertility treatment to stable, heterosexual couples, and states that no more than three cells may be fertilized in vitro and that they must be transferred into the womb simultaneously.

Such tight restrictions, however, have not prevented a series of "test-tube mix-ups" at fertility centers in recent months. In one case, two women had to be prescribed the morning-after pill because each had been inseminated with the wrong man's sperm.

But Sirchia's real problems began this week, after he announced the outcome of an innovative stem cell transplant, carried out at the San Matteo Hospital in Pavia, which cured a five-year-old boy of thalassemia. The new therapy involved using cells from the placenta of both of the boy's recently born twin brothers.

While reporting on the "historic outcome" at a press conference, Sirchia did not mention that the twin brothers were designer babies, born healthy thanks to preimplantation screening and assisted reproduction carried out at a fertility center in Istanbul, Turkey.

"Sirchia wore the peacock feathers for the successful stem cell transplant, but he did not mention the link with a procedure which his law bans. He did hide an important part of the Pavia protocol, fooling around with doctors, patients and, citizens. He has no choice but resign," said Italian Radical Party secretary Daniele Capezzone in a statement.

Members of Parliament, including Alessandra Mussolini, granddaughter of Italy's wartime dictator Benito Mussolini, also asked for the health minister's resignation.

"I was not informed that the pregnancy was done through in vitro fertilization with selection of embryos, as the couple had asked for privacy," Sirchia said in a statement.

Sirchia said the most important aspect in the case was not the in vitro fertilization. "It has been shown for the first time that stem cells originating in the placenta and multiplied in vitro are clinically effective, allowing the donation of placental blood to be used not only in children, but also in adults," he said.

"The twin pregnancy realized with in vitro fertilization and selection of implanted embryos wasn't an indispensable prerequisite to the scientific results obtained. The stem cell transplant can be done, with lower probabilities, with donors born following a natural birth," Sirchia said.

This statement sparked even more controversy. "It was clear to anybody with some medical knowledge that the stem cell transplant was linked to preimplantation screening and assisted reproduction techniques. In other countries, a similar situation would have immediately determined the minister's resignation," fertility expert Carlo Flamigni, Italian pioneer of test-tube baby technology, told The Scientist.

Meanwhile, another axe is going to fall on the health minister. The Green Party has requested that Sirchia explain to the parliament whether there is a conflict of interest regarding his decision to create a structure in Milan for the conservation of 31,000 frozen "orphan" embryos.

Sirchia allocated 400,000 euros for 2004 to the transplant transfusion and immunology centre of the Ospedale Maggiore in Milan–an organization with which the minister has had very close bounds.

"The center in question opened when Sirchia worked with transplants, he was head of the department for about 28 years. The amount of money given to the center is huge. The main cost for embryo conservation is that one of liquid azote, which costs only 50 cents per litre, " Marco Pannella, the founder of the Italian Radical Party, said.

In a statement, Sirchia explained that the money would cover not only the cost of liquid azote, but also "the complex organization of such a center and embryo transport from centers across the country to Milan."

Further research, Sirchia added, will involve the evaluation of cryo-preservation techniques, which would guarantee the embryo viability.

"Apart from the controversy, one would wonder whether it is more dignified for a orphan embryo to be used for research purposes rather than extinguish itself in a freezer," Flamigni said.