says Dr Supriya Puranik, IVF Expert, HOD Obstetric & Gynaecology, Sahyadri Speciality Hospital, Nagar Road, Pune, in conversation with eHealth
Who is an ideal candidate for IVF or ART, and should this be the first choice in the line of treatment?
Couples who cannot have children due to unknown reasons, or repeated failure of IUI (Intra Uterine Insemination) or due to specific reasons like lowsperm count and obstruction in fallopian tube, severe endometriosis have a viable and excellent solution in the form of In Vitro Fertilization (IVF).
How difficult is it to convince couples seeking IVF treatment?
With the increasing awareness, infertility treatment is now becoming more acceptable across all the communities in India. The infertility treatments require the patients to follow a strict schedule in all the procedures, and many of them fail to follow because most of them come from distant places, some have strict work issues, etc. Patients are reluctant to take multiple injection pricks. The late decision of starting with the IVF treatment is one of the major challenges because success rate of IVF sharply falls from 30-40 percent in women aged below 35 to 2 percent in women aged over 45.
Is IVF the only option available? How do you resolve the chances of multiple birthss?
While majority of the patients require fertility enhancing laparoscopic surgeries and basic procedures like IUI, few of them require IVF and ICSI. Although major efforts are warranted to reduce the risk of multiple births with IVF, but it is also clear that single-embryo transfer is not the solution in all the cases.
What are the risks associated with ART?
Possible risks associated with ART include those inherent to pregnancy and delivery, those associated with the infertility itself, and its causes and risks iatrogenic to ART e.g. OHSS i.e. hyper stimulation of the ovaries. Although there are there are many potential risks associated with ART, it has become clear that the major risk is multiple pregnancy and its consequences.
Please shed some light on embryology lab at Sahyadri Hospital
Along with the most modern fertility centre, providing end-to-end fertility solution, we have our embryology laboratory following internationally accepted IVF protocol and global practices. We have invested in technology and expertise to perform complex fer- tility procedures. We have experienced, and highly-accomplished team of IVF experts, embryologists and support staff. We offer individualised fertility treatment with warmth and compassion. We respect confidentiality and patients rights.
What is the success rate of IVF at Sahyadri Hospitals? How different is it from others?
Our hard work and continuous efforts have helped us succeed in IVF cases with a good success rate. Our results are competitive, and are par with the best known. It is important to remember that the maximum you can expect per cycle of treatment would be 8 to 10 percent with IUI, 30-40 percent with IVF and ICSI, 50-60 percent with oocyte donation, embryo donation and surrogacy. However, the good statistics is that the cumulative pregnancy rate with three cycles of the selected treatment would be in the range of 60-70 percent.
We at Sahyadri are committed to transforming the ART technology by ensuring fertility treatment made accessible, available, accountable and affordable.
Are unethical practices on the rise?
There are several ethical issues associated with the infertility treatment. Highcost treatments are out of financial reach of some people, allocation of the medical resources that could be used elsewhere, the legal statues of embryos fertilized invitro and not transferred in vivo, religious leaders opinion on the fertility treatment, infertility caused by DNA defects on the Y chromosome is passed on from father to son in particularly ICSI.
What is your contribution towards fertility tourism?
The form of medical tourism, i.e. fertility tourism is the practice of traveling to another country for fertility treatments. Israel is the leading fertility tourism destinations for IVF procedures, having the highest number of fertility clinics per capita in the world. In turn, India and other Asian countries are the main destinations for the US women seeking IVF, and 52 percent seeking IVF with donor eggs. Hence, a huge growth in fertility tourism is foreseen.
“Today, Indias expertise and technology is being recognized worldwide and the country has emerged as one of the most favoured destinations for IVF“
How does the cost and services of IVF in India compete with other nations?
The affordable IVF treatment cost in India has given a lot of hope to infertile couples who cannot bear exorbitant bills of this treatment in their own countries. Significantly, costs are saved compared to North America and UK. In these years, along with the cheaper treatment option, India has internationally accredited medical facilities using the latest technologies and easy accessibility to facilities such as no waiting lists, etc.
What services you offer by the way of surrogacy?
In cases of end organ failure, such as uterine damage owing to genital tuberculosis, the couple can hope to have their own genetic offspring by IVF with transfer of embryos to surrogate mother who carries the child for nine months, and then hands over the baby to the biological parents.
As you offer surrogacy services, what do you think is the biggest challenge facing the industry in India today?
In addition to possible complications from ART procedures, using a gest tional carrier is expensive, controversial and legally complex. It often involves intricate contracts and arrangements. You will not only experience the usual suspense, and the anxiety of waiting for a pregnancy to safely reach full term, you will have to worry about the legal snags, and the possibility that your gestational carrier will change her mind.
What is the future of IVF in India?
Today, Indias expertise and technology is being recognized worldwide. The country has emerged as one of the most favoured destinations for IVF. In these years, the country has built very sound and state-of-the-art technologies. Moreover, Indian doctors are noted for their expertise and capabilities. The healthcare system is also very cost effective bringing it to the doorsteps of a large global middle-class population. Hence, we at Sahyadri Hospitals provide high-quality treatments in a transparent manner. We believe in sat- isfaction of the patients.