Infertility Specialist, Laparoscopic Surgeon and founder CEO at Gaudium, Dr Manika Khanna has an array of awards and ovation to honour more than 4000 successful IVF treatments. Hailed as the youngest infertility specialist and an honoured philanthropic at heart, she is on a mission to serve the childless couples. In conversation with Shahid Akhter, ENN
According to reports, every fifth couple in India is childless and infertility has risen by 50 percent in the country. Reasons behind the escalation?
Today career planning culminates in late marriages and this often bypasses the healthy reproductive age. Chronic stress kills fertility. Sperm count has diminished to the extent that WHO had to redefine their guidelines, setting the minimum count to 20 million. However other factors, like, increase in radiation levels, pollution, lifestyle, etc., are equally accountable. In India, diabetes and TB are rampant and many are victims of tubal factor infertility. Add to this the graphic rise of Polycystic Ovary Syndrome (PCOS) – hormonal disorder that involves multiple organ systems within the body.
How different is the pregnancy conceived through IVF ? How do you resolve the chances of multiple births ?
Pregnancy remains the same. IVF refers to In Vitro Fertilisation which translates into in lab conception. Here the fertilisation takes place in a petri dish, where several eggs are retrieved from the biological mother. Following fertilisation, the best of embryo is transferred to the mother or a surrogate uterus through a catheter. In order to enhance the chances of success, some IVF centres implant three or more embryos. Consequently, IVF babies are high order pregnancies and they carry the high end mortality risk, birth defects, premature delivery and low weight. In Europe, single embryo is the standard procedure and in the US, single embryo is recommended in women under 35. Multiple births are resolved by way of Blastocyst Culture where the embryos grow in nutrient rich culture for five days (earlier it used to be three). Now the healthiest one is harvested and implanted. There are other means of screening like the Genomic Hybridization, a technique that screens the five day embryo for abnormalities that may lead to failure.
Who is an ideal candidate for IVF and should it be the first choice for the couples struggling for a child ?
In males, if the sperm (semen analysis) is normal and in females if the tubes are not blocked, the couple should explore other options like normal contact cycle and IUI should be considered first. IVF benefits women with blocked fallopian tubes and those infertile men who cannot overcome with IUI treatment. In IVF the embryo is transferred to the uterus via the cervix, IVF does not require open, clear fallopian tubes. Similarly, men with low sperm count or no sperm (azoospermia) or malformed sperms or low sperm motality can have their sperm extracted from their vas deferens. Sperm is then injected into the egg using ICSI and the chances of pregnancy is much higher. IVF may also help those with unexplained infertility. IVF can help those who want their eggs or sperms to be frozen and activated as and when they want. Advances have been made in sperm and egg preservation. Besides IVF, it benefits so many, like those in the army and navy or career conscious couples who may want to have their eggs and sperms stored in a designated bank for future use.
What is the IVF success rate at Gaudium and its USP ?
At Gaudium we begin with a counselling session where we do our best to answer all questions to the satisfaction of the couples. Unanswered questions, doubts and queries will breed confusion and this will add to stress. We emphasize on harmony to prevail so that the problem is discussed and a solution chalked out. Our overall success rate is around 50 percent and so far I have successfully catered to over 4000 IVF treatments.
How does the cost of IVF in India compare with that of the US and Europe ?
The government rates are possibly the cheapest in AIIMS. Under similar parameters and services, I can safely say, Indian IVF centres charge anywhere between 1/3 and 1/4 of their counterparts in the West. This is the reason there is a good influx of foreigners who find India as a good IVF destination.
Can this be a factor in the promotion of medical tourism ?
Certainly, it is already there and in a big way!
Each country has its own IVF and surrogacy laws and protocol. How about India ?
As of today ICMR guidelines are in place and we follow that but soon we will have full fledged laws. Hopefully they emerge soon from the Parliament. Countries like UK and US are very open to surrogacy laws. However, Europe is divided. In some places commercial surrogacy is not at all considered legal. Precisely for this reason, when a foreigner approaches us, we begin with the nationality and their respective laws.