Growing problem

According to experts, the rise in the marriageable age and a number of other factors like Policystic Ovarian Syndrome (PCOS) among women, lifestyle factors like alcohol and tobacco consumption are the main factors in the increasing infertility cases among Indians. 

For those battling infertility, In Vitro fertilisation (IVF), a part of Assisted Reproductive Technology (ART), through which an egg and sperm are manually fertilised in a laboratory dish and then transferring the embryo into the uterus, has been a boon for several couples. However, of late, there has been a perpetual rise in the number of centres city and experts say that an unchecked boom is worrying. 

According to sources at the Directorate of Medical and Rural Services, as many as 30 centres function in the city under the purview of the department. The source adds, “However, there are several other clinics that have applied for licenses and we are in the process of evaluating their credentials.” The source also says that while the ART Bill is still pending, the license is not binding on the clinics and they fear there might be a larger number of them operating in the city. The source says, “But we follow up on the performance just to ensure there is no violation of the PC-PNDT Act that forbids sex determination.” 

Dr JA Jayalal from the Tamil Nadu Medical Council (TNMC), says that the aggressive marketing sends out wrong signals. “We have pulled up a few that have made claims saying they can guarantee a baby and the success ratio is 100 per cent, but scientific evidence shows it is just about 40 per cent or a little over it. In fact, one of them even went about publishing a huge picture of the doctor running the centre in their advertisements and after we made them reduce his photograph to a passport size one,” he adds.

Child bearing issues have psychological implications on couples, says Dr Mini Rao, clinical psychologist. “It can be a huge burden for them and I have even had couples who are having infertility issues and one of the partners having difficulty coming to terms with it. Any hope offered to them should be on practical grounds,” she says.

Take the case of Sunitha (name changed), an academician, who went for two IVF cycles and both failed. She says, “I was told it was due to stress, but I am still not sure if I should stop trying through this method.” 

Unlike Sunitha and her partner, there are many who cannot opt for the treatment. A report ‘Call for Action: Expanding IVF treatment in India’ published by Ernst and Young (EY) in 2015 says that IVF is beyond access for as many as 80 per cent of the infertile population as they need multiple cycles. 

With one cycle costing anywhere between Rs 1.5 lakh to Rs 2 lakh, a huge section of middle and lower middle income groups is left out. Dr TK Shaanthy Gunasingh, Head of Department and professor, Department of Obstetrics and Gynaecology, Kilpauk Medical College Hospital, says that as many as 10 per cent of patients who visit the facility, require IVF. She says, “But they are unable to avail the services due to high costs. There are facilities that offer low cost procedures, but we need a lot more penetration of the same.”

The facility will soon be launching IVF treatment, she says. “The high cost is often due to imported drugs that are used. Over the years, the success rates have also gone up to as much as 60 per cent. At least that’s what many in the market claim,” she points out.

The proposed ART (Regulation) Bill aims to ‘establish the National Advisory Board, the State Advisory Boards and the National Registry for the accreditation, regulation and supervision of assisted reproductive technology clinics; assisted reproductive technology banks, for prevention of misuse of assisted reproductive technology including surrogacy; for safe and ethical practice of assisted reproductive technology services and for matters connected therewith or incidental thereto.’ Voicing support for the procedure, Dr PSR Murthy, chief embryologist and scientific director, Miracle Advanced Reproductive Centre, says, “Anyone who wants to know the success rates for any clinic would be able to get the information from the registry directly. This could prevent misconceptions.” He says natural pregnancy has just about 30 per cent success. “So, if nature has 70 per cent of failure chances, we need to understand the limitations of IVF. It varies depending on the age of the women, the number of eggs, etc. We have had cases where older couples have had children through the procedure— that sends a wrong message to the public,” he says. He adds that several linics opt for multiple embryos. “If it results in triplets, and they don’t want all three and then they do a foetal reduction, such things can trigger a lot of stress,” he says.