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Assisted fertilisation, or artificial fertilisation, is a medical reproductive technique through which two gametes are artificially united.
Gametes are mature reproductive or germ cells and are divided into male (sperm) and female (oocytes).
Assisted fertilisation is synonymous with assisted reproduction.

We speak of homologous fertilisation when the sperm and oocyte used belong to the parents of the unborn child, from whom it will receive its genetic heritage.

Assisted fertilisation, or artificial fertilisation, as it may be called, includes techniques such as intrauterine insemination, IVF, ICSI, MESA, TESA, etc.

To find out more about the various techniques used at the CMR (Centre for Reproductive Medicine) and assisted fertilisation visit this link. IVF can also be completed with PGT to transfer embryos free of genetic defects.

Heterologous fertilisation occurs when the sperm or oocyte comes from outside the couple.

This reproductive technique is now permitted in Italy, thanks to amendments to law no. 40 of 19th February 2004 concerning “Regulations on Assisted Reproduction”.

This law has created strong arguments about its 'constitutionality', so much so that, since its inception, it has already ended up five times in all in front of the Constitutional Court - in 2005, twice in 2009, once in 2010 and once in 2012 - and seventeen times in all if one also adds court rulings.

The last time was on 28th August 2012, when the European Court of Human Rights in Strasbourg called Law 40 into question, ruling in favour of Rosetta Costa and Walter Pavan, who, as healthy carriers of cystic fibrosis, had requested assisted reproduction and pre-implantation diagnosis.

On 28th August 2012, the European Court of Human Rights in Strasbourg called Law 40 into question, overturning a ruling issued 19 months earlier by one of the chambers of the same court.

In fact, in November 2011 the same Court issued a ruling prohibiting, by law,infertile couples from resorting to heterologous in-vitro fertilisation. The judgment concerned two Austrian couples for whom in vitro fertilisation with sperm donation was the only possibility of having a child, claiming, therefore, that they were discriminated against in comparison with other couples who could resort to this technique.

This time the story concerns two Italians, Rosetta Costa and Walter Pavan, who, following the birth of their first child, suffering from cystic fibrosis, discovered that they were both healthy carriers of the same disease.
This meant that if, as they wished, they wanted to have another child, they would have to deal with a 25% chance that he or she would be born with the disease and a 50% chance that he or she would be a healthy carrier.
Assisted reproduction and pre-implantation genetic testing was the only possibility of not running this risk, but Italian law does not allow it, which is why the couple appealed to the Court of Human Rights, arguing that the legislation violated their right to private and family life and discriminated against them in relation to infertile couples and those in which the man has a sexually transmitted disease.

The Court issued its ruling, which became final in February 2013, despite an appeal by Monti and the Italian government, decreeing the interference of Italian assisted fertilisation legislation in the exercise of private and family life enshrined in Article 8 of the European Convention on Human Rights.

According to the judges, the lack of coherence is caused by the fact that on the one hand, Law 40 of 2004 prohibits the implantation of only embryos not affected by cystic fibrosis, while on the other hand, the law on the termination of pregnancy authorises parents to abort a foetus affected by the same pathology.

With the rejection of the government's appeal by the Court of Human Rights, Law 40 will have to be brought into line with the European Charter of Human Rights, providing access to medically assisted fertilisation techniques also for fertile couples who are carriers of diseases that can be transmitted to their children.