Campania: 3% of children born from assisted reproduction techniques. The average age of women who have resorted to PMA rises to 36,3 years

Naples. In Campania, between 2010 and 2016, approximately 47.000 couples with fertility problems turned to the region's over 40 medically assisted procreation (PMA) centers to realize their desire to have a child. In the same period, over 9.000 children were born alive thanks to various assisted fertilization techniques . According to data from the latest Report, 1.331 children were born in 2016 – an increase compared to the previous year – just under 3% of total births ^[1] . This growth is dictated by an increase in infertility in a population that is deciding to have children at an increasingly later age. These are some of the data that emerged from the meeting “Beyond Mothers: the desire for motherhood and ovarian exhaustion” , which took place today at the Infertility Centre of the University of Campania “Lugi Vanvitelli”, one of the public centres of excellence in the region , where a fertility preservation service for cancer patients is also active, carried out through cryopreservation and banking of seminal fluid and oocytes, and collection and cryopreservation of ovarian tissue.

"Couples who come to our Center are welcomed by a multidisciplinary team (comprised of gynecologists, obstetricians, urologists, andrologists, psychologists, biologists, and embryologists), who carefully guide them through a diagnostic and therapeutic process aimed at achieving pregnancy," says Professor Nicola Colacurci, Director of the Infertility Center at the University of Campania "Luigi Vanvitelli" and President of the Association of Italian University Gynecologists (AGUI). In the two-year period 2017-2018 , he continues, of the 1.727 couples seen, approximately 20% were indicated for Level I (Intrauterine Insemination), Level II (IVF-ICSI), or TESE (Surgical Sperm Retrieval) ART, with the option of performing the procedures either with fresh or cryopreserved sperm, oocytes, and/or embryos. At the Centre, 350 cycles of level II PMA have been carried out , with an average success rate per transfer, or rather of pregnancies obtained, of 31% . In the field of PMA, in recent years medicine has made great strides forward, with a significant increase in pregnancy rates obtained, despite the progressive increase in the average age of women who resort to it, which, in Campania, is 36,3 years ^[2] . The percentage of women over 40 who access PMA is equal to 31% ^[3] , in line with the national scenario, which sees 7,3% of women giving birth after the age of 40 ^[4].

“ Postponing the age at which one chooses to become parents is becoming increasingly frequent, due to personal choice, but also due to the difficulty in achieving a stable life as a couple and having a secure job. Science today allows us to overcome many obstacles, but we must not forget that pregnancy at an advanced age is more complex, both from a physical point of view and for the related psychological aspects”, comments Prof. Colacurci. Furthermore, there is an ever-increasing number of couples who decide to resort to heterologous fertilization through egg donation , a technique included in the new Guidelines on PMA updated in 2015. However, the demand for heterologous fertilization does not find an adequate response in our country, due to the reduced number of donations, partly attributable to a lack of information on this procreative opportunity: in 2016, in fact, the percentage of oocytes imported from abroad was 69,3% of the total used ^[1] . In Campania, the recent Commissioner's decree on assisted reproduction – Decree No. 21 of February 4, 2019 – has implemented the criteria for access to homologous and heterologous medically assisted reproduction techniques and the conditions for provision set out in the new Essential Levels of Assistance (LEA), establishing access to assisted reproduction for women up to the age of 46 and for a maximum of six treatment cycles. "Couples with fertility problems who wish to realize their dream of having a child can turn to the Public Service for Access to Assisted Reproduction , obtaining an effective, efficient, and highly skilled service ," concludes Professor Colacurci.