Padma Shri Dr Indira Hinduja delivered Indias first test tube baby at KEM Hospital, Mumbai, in 1986. She is also credited for the countrys first babyby an oocyte donation technique back in 1991. Honorary IVF and Infertilityspecialist at PD Hinduja National Hospital and Medical Research Centre,Mumbai. In conversation with Rachita Jha, ENN

Please share with us how has IVF technology advanced over the years?
In vitro fertilization or IVF has been in the medical sciences since 1978 and is currently on the frontiers of medical technology and innovation. During my practice in 1984, the equipments like incubators and microscope needed for the procedure were not solely dedicated for IVF and media needed were prepared in-house. There was scarcity of good drugs needed for the treatment that lowered the chances of pregnancy. Disposals,injections were not freely available and other instruments like catheters were sterilised and reused many times.
Technology has now advanced by leaps and bounds. Technique of retrieving the oocytes and transferring the embryos into the endometrium has advanced. ICSI (intra cytoplasmic sperm injection) has now replaced IVF. Now facilities like Intracytoplasmic morphologically-selected sperm injection (IMSI) which allows selection of the best sperm to be used for injection has lead to an increase in the pregnancy rate. Machines like polscope help to determine the quality of the oocyte and embyroscope help to assess the eminbryo quality in real time, have proved to be a boon to this field. The advent of Preimplantation Genetic Diagnosis (PGD) now allows us to select the best embryo free of any inherited disease.These were only a few of the advances and with active ongoing research in this field sky is the limit.
Also people are becoming more aware of this technology thanks to the media exposure which was not present during the initial days. Each year we see the arrival of new techniques or technology advancements that help doctors offer more options for parents-to-be. The sector is doing extremely well and the evidence is on the improved success rate that stands close to 50 percent today. The technology in future is sure to become more patient friendly as the quality of facility and success rate improves in the coming years.

Have you witnessed an increase in the number of patients opting for IVF?
Yes definitely. Today there are patients coming up with different kinds of infertility problems that were unheard of previously.Drastic changes in the lifestyle and the associated stress has taken a toll on the overall reproductive health of the people, because of which there has been a steady rise in the number of couples visiting the infertility clinics. A combined effect of technology, awareness campaigns and specialty clinics has brought IVF in the mainstream of treatment options for infertility in India, more so that the techniques are now very well known even in remote areas. Thus today among majority of the popular techniques and specialities,IVF is one of the top in the list. The concept of infertility is not new; it is only the techniques, results and applicationsthat keep changing. And this demand and need for better success rate is also ushering progressive technology breakthroughs in reproductive sciences.

India has the best state-of the-arttechnology and techniques in IVF compared to anywhere in the world

Tell us some of the critical elements in IVF for a facility?
The most important component is the drugs to grow the eggs in the woman, followed by the technique of collection of the egg. Recently new methods of egg and sperm screening and studying if it is normal or abnormal have been introduced that has really improved the success rate. We can now predict certain disease and probability of genetic disorders in the embryo using latest techniques. This has revolutionised the IVF practice. The next important aspect is to transfer the best embryos which needs critical uation from the number of embryos obtained. There has also been an increase in the number of drugs that improves the quality of the endometrium.We can now have known insight on the potency of the endometrium to grow – empowering doctors for better decision-making.

Please tell us some of the exciting projects in IVF that researchers are working on?
We are now working towards improvement of the results and quality of the embryo and eventually the baby. Reproductive sciences are now being used in the treatment of other diseases. The origin of stem cell therapy came from the unused embryo obtained from IVF that was used as a treatment of majority of diseases. Now due to ethical issues to use embryonic stem cells, research is ongoing to develop new ways to develop stem cells that have embryonic stem cell characteristics. Maybe, the future belongs to cloning and many research organisations are already doing pathbreaking work. There is a lot of research being done in this field in India as well, and this will surely be the next exciting phase of IVF or Assisted Reproductive Therapy (ART). We are now putting our efforts in understanding the reason behind women failing to conceive – and we are on the point of breakthrough in that.

Is India comparable to the world in the delivery of IVF services?
We are comparable to anywhere in the world, and in fact are a step ahead in terms of practice and number of patients we cater with and-on-experience.Facility wise as well, we are in no aspect inferior to the rest of the world.India has the best and state-of-the-art technology and techniques available compared to anywhere in the world.In some aspects we are better and in some we are at par. That is the reason for the rise of medical tourism in the IVF and ART sector, because we offer world class quality of service and expertise at better cost advantage

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