On the risks of the ROPA method

The technique used by an increasing number of lesbian couples consists of using the oocyte of one to make an embryo that will then be inserted into the womb of the other who will carry the pregnancy. This practice is physically and psychologically dangerous both for the two women and for the child that will be born. This is why
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In our recent communiqué For the true good of children we expressed our concern about the increasing use of the ROPA technique by female couples (Recepción de ovocitos de la pareja) or the ttransfer of the fertilised oocyte of one into the womb of the other that will conduct the gestatione.

For this stance, we received acclaim, a few insults and many requests for information and sources.

What does the ROPA method consist of and what are its risks?

For the woman who provides the oocyte there is a ovarian stimulation with synthetic hormones and egg retrieval under general anaesthesia. The oocytes are then fertilised in a test tube with sperm from a sperm vendor. At a certain stage of development the zygote or embryo is inserted into the uterus of the other woman, after ovarian stimulation to simulate the hormonal changes that would occur in a natural pregnancy.

Sui even oncological risks of ovarian stimulation with hormones for assisted fertilisation the studies are numerous: see for example In the belly of another by eco-feminist lecturer Laura Corradi.

In addition, the woman who is carrying a child whose genetic make-up is totally foreign to her is greater risk of miscarriage.

La difference between the practice of surrogacy and the ROPA method -besides the fact that there is no contract and market here, apart from the purchase of the semen and the costs of the medical practice- is that in this case the two women involved are a couple and not two strangers. The risks for the women and the child are exactly the same.

La success rate of all medically assisted procreation techniques is very low, only in 2 out of 10 cases does the pregnancy reach full term (clinics speak of 8-9 cases out of 10, but they refer to pregnancies that start, not to those that end successfully). Furthermore children born by assisted reproduction (all techniques) have a 'statistically significant increased risk' of developing various diseases, including cancer, as explained by head of the Paediatric Oncology Department at the Istituto dei Tumori in Milan Maura Massimino in the interview which we report below.

The interview conducted at the end of 2017 mentions several studies whose results have been confirmed by follow-ups and numerous other studies, and the correlation between medically assisted procreation and children's cancers is now the subject of paediatric oncology conferences.

One last remark on the ROPA method, before offering you the interview:

two healthy women can easily achieve a physiological pregnancy in other ways, and have no need to resort to the expensive and physically demanding ROPA method. In fact, not all lesbian mothers become lesbian in this way.

Then why an increasing number of female couples are resorting to this techniquewhich puts their health and that of the child at risk?

The reason is mainly ideological and has to do with the fantasy of one woman 'impregnating' another just like a man. The oocyte of one implanted in the body of the other symbolically replaces the male seed. This also the male contribution is further designated and its depowered ghost.

The ROPA technique is not synonymous with 'lesbian motherhood', but a market product that is cynically offered to female couples by encouraging phallic fantasies, to the detriment of their own health and especially that of the unborn child.

Also encouraging the use of ROPA is the fact that it might be easier to obtain the full transcription of birth certificates which would indicate not only the mother who gave birth -semper certain- but also the woman who provided the oocyte and who is to all intents and purposes the genetic mother.

Le reasons for opposing the dissemination of the ROPA product are many, from the protection of women's and children's health to opposition to phallic-technological symbolism.

A woman who has no reproductive health problems, whether heterosexual or lesbian, single or in a couple, can become a mother without having to turn to the technomarket: there is no need.

Maria Celeste

'More cancers in test tube babies': interview with paediatric oncologist Maura Massimino

Sui rischi del metodo ROPA

"Children conceived as a result of fertility treatments (and of course those born from IVF, ed.) are at higher risk of childhood cancers'. It is the conclusion of one studio published last March by theAmerican Journal of Obstetric & Gynaecology*. The study is particularly significant because it is based on 18 years of follow-up, orvvero followed boys and girls from birth to eighteen years of age.

Numerous other studies come to similar conclusions. Let us look at some of them.

Research carried out in Israel and published in October 2016 by Paediatric Blood & Cancerthe scientific journal of the SIOP (International Society of Paediatric Oncology), identifies among IVF births 'a statistically significant increased risk' in particular 'for two types of childhood cancer': retinoblastoma and kidney tumours.

Another Norwegian study, published by Pediatrics in March 2016, observes 'a increased risk of leukaemia' and "a high risk of Hodgkin's lymphoma in children conceived with assisted fertilisation'. Research published by Human Reproduction (Vol. 29 - No. 9, 2014) observes in IVF births 'an increased risk of central nervous system tumours and malignant epithelial neoplasms'.. Other studies note an increased risk of congenital malformations as well as pre-term births.

The comparison of 38 studies published in March 2015 by Fertility and Sterility (vol. 103, no. 3) indicates that "children conceived with assisted fertilisation may be at greater risk of non-specific infectious or parasitic diseases, asthma, genito-urinary problems, epilepsy or convulsions, as well as longer hospital stays'.

Maura Massimino directs the Paediatric Oncology Department of the Istituto dei Tumori in Milan. "Recently" confirms "in the medical history sheet of the young patients we also introduced the request for information on conception, whether it was natural or assisted'.

Does your daily practice confirm the findings of studies and research, i.e. an increased risk of cancer in children born of assisted reproduction?

"It has been at least a decade that we see sick children born from assisted reproduction. The studies published in scientific journals, all of which pass under a careful peer-review (peer review, ed.) justify growing alarm. The data are more and more significant, the observation is more accurate, and now the follow-up up to 18 years of age'.

What types of tumours do you observe in these children?

"In the 0-3 age group the most frequent are retinoblastoma, kidney tumours and hepatoblastoma. But the increased risk reported in the literature concerns all tumour types, with blood cancers being particularly prevalent. As well as a number of non-oncological diseases, which have also been verified by studies'.

Is there also a risk of transmissibility of any genetic abnormalities carried by persons born as a result of assisted fertilisation?

"There are genetic syndromes that are accompanied by an increased risk of developing tumours, but so far their transmissibility does not appear in studies".

When you arrive at a diagnosis of cancer in a child born of assisted reproduction, do you verify that the parents were informed of the risk?

'Never. I have never come across a conscious couple. You say: ah, he was born by IVF! and they open their eyes wide. No one had warned them of anything. Paradoxically, it is more often the grandparents, who are less confident about these technologies, who relate the disease to unnatural conception'.

Are couples not notified at the informed consent stage?

"We are not aware of the content of the information.

Does the increased risk affect all IVF techniques?

"Initially, it was believed that the technique with the highest risk was Icsi (Intracytoplasmatic Sperm Injection, an assisted fertilisation technique that consists of the microinjection of a single spermatozoon directly into the oocyte cytoplasm, and is today by far the most widely used of the second-tier techniques, ed). But As the studies proceed, it seems that the differences between one technique and another are not significant'.

How do we explain this increased risk of cancer and other diseases among children born as a result of assisted reproduction? Is it a consequence of the hormonal therapies to which the mother (and/or the pregnant woman, in the case of surrogacy, or the egg donor?) is subjected? Does it depend on the often advanced age of the parents? Or what other factors?

"In my opinion, but I am neither a gynaecologist nor a geneticist, the problems may have to do with the fact that these techniques replace natural selection: not all oocytes forced to mature with ovarian stimulation would have matured naturally, probably because they were not the most 'suitable' for procreation. Even for spermatozoa, selection in the laboratory does not exactly reproduce natural selection. In a way, one could argue that gametes used in assisted fertilisation are not with certainty the best. And probably not all embryos made in test tubes, implanted and supported with hormone therapies, would have developed under natural conditions. In addition the microenvironment in which the early stages of embryonic development occur is different from the female womb: for temperature and light conditions, biochemical information, immune system...'.

Many people, thinking about pre-implantation diagnosis techniques on embryos, believe that children born through IVF are healthier than those conceived naturally.e.

"I do not venture into this territory. All I am saying is that From the data in the literature, the opposite would seem to be the case. Children born from IVF run a higher risk of both connatal - i.e. at the time of birth - and later pathologies'.

Data that are now numerous and incontrovertible: is there an information and prevention plan for these risks linked to assisted fertilisation?

'No plan. I have never seen the issue raised at international oncology conferences or symposia'. (In the years since 2017, when the interview was conducted, numerous international conferences on paediatric oncology have focused on this topic, ndr)

Many young people seem convinced that they can postpone procreation until the age of 40, possibly by freezing oocytes or by other assisted fertilisation techniques.

"Egg and sperm freezing originated in oncology in order not to deprive young people undergoing invasive therapies of the possibility of having children and to plan their return to normalcy, which we all hope for. But I believe that in the light of these data - the health risks for women and children - it is very inadvisable to resort to assisted fertilisation when there is no strict necessity, linked to pathologies that threaten fertility permanently. Great caution is needed. Children must be made when they come easily and naturally. The conditions, including social conditions, must be recreated for this to be possible again'.

* Wainstock T, Walfish A, Shoham-Vardi I et al, Fertility treatment and paediatric neoplasm of the offspring: results of a population-based cohort with a median follow-up of 10 years.

Marina Terragni

(an abbreviated version of this interview was published in Advent of 10 December 2017)

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