After six attempts to get pregnant, Federica Casadei can’t face another round of gruelling hormone therapy and surgery at her Rome fertility clinic.

“I’ve given up hope of conceiving a child in Italy,” she said. “The doctors are at the vanguard but our politicians have made it impossible, so we’ve decided to go abroad.”

Casadei is not alone. The number of infertile couples seeking help abroad has tripled since lawmakers in Roman Catholic Italy crossed party lines last year to approve one of Europe’s most restrictive laws on assisted reproduction.

They wanted to crack down on what many saw as a medical Wild West where a 62-year-old woman had become a mother and a maverick doctor has bragged about cloning babies.

But far from ending the controversy the legislation has sparked the most heated moral debate since divorce and abortion were legalised in the 1970s and has prompted Pope Benedict, elected in April, to make his first foray into Italian politics.

This weekend the standoff will come to a head with a four-part referendum that, if passed, would significantly change the law. The poll has shattered traditional political alliances and elicited emotional appeals from church pulpits.

ATTACK ON WOMEN’S RIGHTS

“Yes” votes would lift a ban on egg and sperm donors; allow embryo freezing and research; and remove limits on the number of eggs that can be fertilised during each attempt.

The referendum also aims to change language that gives embryos full legal rights and prevents diagnosis for genetic disorders before they are transferred to the uterus - even though women can then abort a foetus that has disorders.

“This law is an attack on the rights of women,” Equal Opportunities Minister Stefania Prestigiacomo told. “If the referendum doesn’t pass, the law could become untouchable and even raise questions about the legality of abortion.”

Prestigiacomo was the first government leader to break ranks with Prime Minister Silvio Berlusconi’s administration, condemning the law and urging “yes” votes in the referendum. The defence and foreign ministers soon followed suit.

Indeed, the nationwide ballot has defied political definition sparking a bitter and emotional battle drawing in doctors, actors as well as the pope.

Bishops have urged Italians to boycott the referendum and political leaders from left and right who are against the referendum have rallied behind the slogan: “Life cannot be put to a vote: don’t vote.”

If less than 50 percent of voters participate in the ballot being held on Sunday and Monday, it will not be valid.

POPE BENEDICT STEPS IN

Pope Benedict plunged into the debate in two public appeals, calling bishops “truly good pastors” for trying to “enlighten the choices of Catholics” in the referendum battle.

Priests have called on Italians to abstain from voting during Sunday masses and posters with the slogan “We are all ex-embryos” have appeared across the country.

A failed referendum, which appears increasingly likely, would be seen by many as a victory for the new pontiff at a time when the Church is losing influence in most developed countries.

Polls show most Italians oppose the law but may not feel strongly enough about it to sacrifice a weekend at the beach.

A group of doctors went on strike to raise the profile of the “yes” camp, which is also supported by Nobel prize-winning scientists and actress Monica Bellucci who famously demanded “What do politicians and priests know about my ovaries?”

Berlusconi has kept his views to himself, but he joked that the referendum’s mid-summer date - which critics say was a move by the government to ensure low turnout - could “spark a row” with his wife Veronica, who is pro-referendum.

HOLY INQUISITION?

Not surprisingly, Severino Antinori, the notorious fertility expert behind Italy’s 62-year-old new mother denounced the law, which he called a “Holy Inquisition” against medicine.

But much of Italy’s medical community is also critical.

“People are angry. They feel that their future as parents is being destroyed by politicians and the Church,” said Pasquale Bilotta, director of the Alma Res fertility clinic in Rome.

He said that the law has had a negative impact on up to 40 percent of the 200,000-300,000 Italian couples who seek fertility treatment every year.

The ban on donor eggs and sperm prevents sterile and infertile couples from conceiving, while couples at high risk to genetic disorders cannot seek fertility treatment or DNA testing of embryos.

Women over 40, like Casadei, have to undergo repeated treatment because they cannot fertilise more than three eggs at a go or freeze embryos for future attempts.

“This is such a long and painful process and the law has just about ensured it will be a failure,” she said.