In Italy, the pope wants to restrict human fertility treatment, but UK researchers have found that relationships in donor and IVF families are unusually strong
Severino Antinori, Italy's charismatic pioneer of medically assisted reproduction and godsend to the country's estimated 18 per cent of sterile couples, is fighting for survival.
Antinori, 55, has been christened by the national press "the miracle father of impossible children", but the Roman Catholic church feels that this is one miracle it can do without.
Vatican pressure for stringent measures on fertility treatments could force Antinori to close shop and emigrate, continuing the tradition of Italy's top scientists, including Nobel laureates Rita Levi Montalcini and Renato Dulbecco.
A church-backed bill has just been blocked by a surprise vote after a battle in the Italian parliament, but Italy's rightwing, which is favourite to gain power next year, says it will press for legislation on the basis of the same bill after the elections.
At the infertility unit of Antinori's international research centre, just 500 yards from St Peter's in Rome, baroque paintings in the luxurious reception portray winged cupids, wistful maidens, madonna-like matrons and chubby-faced children. A plaque from one of his 2,000-plus satisfied couples expresses eternal gratitude to the "caro professore" for turning a dream into reality; another warns patients that though the centre boasts good results, it does not perform miracles.
Antinori's clients, many of whom are British, come from all walks of life. Some are top international names in sport, cinema and world affairs. He was even approached once, he relates, by a handsome 39-year-old gentleman with a zero sperm count (azoospermia), who turned out to be a Catholic priest. The man later phoned to cancel his appointment and was never seen again.
But now "the miracle father" is fuming and seeking international support. "This is a law aimed not just against progress but against humanity itself. It is based on a fundamentalist religious ideal that is even more dangerous than that of the Ayatollah Khomenei. This is not just obscurantism in the face of the pursuit of truth - it is an inquisition."
Antinori warmly acknowledges the support of the British medical world during his years of persecution by the Vatican. "For four years, they tried to crucify me with an avalanche of libel and slander - and all because these people demand absolute power over man and science. In Italy we have the Roman Catholic church, which persecuted Giordano Bruno and Galileo Galilei. Basically nothing has changed since then - it's just that nowadays they do it differently. The situation cannot be allowed to go on."
Trouble began in 1986 when Antinori started experimenting on sperm injection techniques in cases of male infertility. The news produced a wave of defamatory statements against him in the Catholic press. He raised three legal actions, won them all and will donate the proceeds to the scientific community. His persecution by the church is, he argues, an implicit condemnation of all researchers who try to work freely and objectively. For him, the latest Vatican move for legislation could be the last straw.
Italy has no national legislation on fertility treatments. It relies mainly on regulations laid down by the Italian medical association's code of ethics, which were last updated in 1994. But Pope John Paul II is pressing for the introduction of laws to regulate medically assisted human procreation.
The proposed legislation sanctions in vitro fertilisation in Italy under a licensing and monitoring system that seeks to protect the rights of all involved, "especially those of the conceived". It is said to be inspired by the British Human Fertilisation and Embryology Authority model.
The bill states that no more than three cells may be fertilised in vitro and they must be transferred into the womb simultaneously. In Britain, the HFEA limits the transfer of embryos to a maximum of three to avoid multiple births, but there is no limit on the number of cells that may be fertilised. Antinori, whose clinic has a low percentage of multiple births, says fertilising fewer than eight cells would cut his 30 per cent pregnancy success rate to as little as 3 per cent.
The bill's limitation of fertility treatment to women "of a potentially fertile age" would also exclude menopausal subjects, an area in which Antinori has been a pioneer. In 1989, Antinori's patient Paola R. became the first menopausal woman in history to give birth, after a donor egg implant. Since then Antinori has helped about 80 women over the age of 50, in advanced menopause, to "realise their impossible dream". Among them was Rosanna Giorgi Della Corte, 63, who in 1994 became the oldest woman to give birth.
In addition, both surrogacy and the use of third-party donor sperm and eggs would be outlawed by the bill. In Britain the HFEA last year approved the first bulk import of sperm from Denmark to meet growing needs, having lifted the ban on paid egg-sharing a year earlier. HFEA chairwoman Ruth Deech has said that a culture of altruism in sperm and egg donors should be encouraged. "Again you see that here in Italy we are in the dark ages compared with countries such as Britain," Antinori says. "What is it if not an act of love to help a woman with no uterus? Although our church preaches a lot about love, it seems to have little understanding of such matters."
Finally, the bill's prohibition of all experiments on individual human embryos would, Antinori argues, kill the field of assisted reproduction in Italy stone dead. Antinori supports human cell nucleus replacement, or cloning, for the therapeutic help it could provide in the treatment of cancers and of Parkinson's and Alzheimer's diseases. He also supports the cloning of sperm in cases of azoospermia, but he opposes the cloning of human organs.
The proposed legislation would impose severe penalties on doctors, including from ten to 20 years in prison and fines from Pounds 50,000. Neither "parent" involved in illegal use of third-party donor sperm or eggs would be able to disclaim legal parenthood.
In its present form, the bill could face challenges on the grounds that it unduly limits freedom and fails to give an adequate legal definition of a potentially fertile age and of those legal persons whose rights are being protected. Should it become law, recourse to the Italian constitutional court would be almost automatic.
Some have already resorted to the courts. Earlier this year, a Rome doctor, Pasquale Bilotta, won an appeal in a case brought against him by the national medical association for using egg-sharing treatment. The association says it will present a counter-appeal at the Supreme Court. And a doctor in Pavia, Cesare Galli, who recently had his cloned bull confiscated by police and his laboratory placed under sequester, is reportedly also taking legal action.
Antinori, who despite international recognition and a string of respected publications, has been unable to secure a tenured post, is scathing about the state of university research. "Mine is a cry of distress because the cream of Italy's scientists are forced to go abroad. The mechanisms that characterise the Italian university system and research need to be changed completely by sweeping away the whole bureaucratic, administrative and religious world. There is always this religious spectre behind everything in Italy."
So disillusioned has Antinori become with politicians that he founded a political movement, Autonomia Liberale, which won an encouraging 8,000 votes at local elections in Lazio. He is backed by other radical freedom-fighters such as Antonio Di Pietro, the "clean hands" magistrate-turned-politician.
So far as the threat to his fertility work goes, the first round has gone better for him than expected. But the reappearance of former Christian Democrat prime minister Giulio Andreotti as a guiding force to Italy's Catholic politicians promises a fiercer battle ahead.
Meanwhile, the pope, who insists that the suppression of a human cell's "right to life" is fundamentally immoral, concluded his jubilee speech to an audience of 7,000 international academics last month with the statement that moral demands based on an awareness of the limits of science are not obscurantist.
Italy's miracle father is putting up the fight of his life, but he may need something of a miracle if he is to withstand the crushing power of the holy Vatican.