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Assisted conception

Advances in aided reproduction technology is delivering results even in complex infertility cases. Nivedita Khandekar writes. Medical history made with birth of the first test-tube baby | Great expectations

health and fitness Updated: Mar 20, 2011 01:15 IST
Nivedita Khandekar

Dr Manika Khanna has granted Archana, 25, and Mantu Charan Jana, 30, what nature denied. It's because of her medical expertise that the childless couple is expecting a baby later this week.

Infertility affects one in 10 couples worldwide, of which 19-20 million live in India, says the World Health Organisation. Though in-vitro fertilization (IVF) techniques - popular referred to as test-tube babies - still does not promise 100 % success, advances ensure childless couples have a greater chance of conceiving today than ever before. Some clinics in India show 50% success, compared to the global average of 40%.

The IVF procedure involves extracting an egg from a woman and fertilising it in a lab-dish using the husband's or donated sperm. When the egg divides and develops into an early-stage embryo, it is inserted into the uterus where it develops into a baby.

"About 10-15 % of our clients have age-related infertility. Urban working women want to have children late, little realising that fertility starts declining after 33 years," points out Dr Sushma Sinha, senior consultant, IVF at Indraprastha Apollo Hospital.

"With each passing year after 30, the graph of success rate for IVF goes down. And beyond 40 years, it is only 5 %," says Dr Khanna.

Other common causes for infertility are blocked fallopian tubes due to tuberculosis, male infertility (contributing to as much as 45 %), hormonal imbalance and, in some cases, fibroids in the uterus.

With most couples thinking of starting a family after the age of 35, infertility clinics are generally the place to start. But IVF centres require physical and emotional rigour that can test the toughest of couples.

Soma Sharma, a housewife from Shashtri Nagar in Delhi, had twin sons in February after undergoing IVF treatment.

"There were no side effects whatsoever due to injections, but waiting for the results of the treatment has harrowing. I was so desperate for a baby after undergoing weeks of injections," says Sharma.

"Also, the thought whether the hormones being injected will be a problem gnawed till my pregnancy was confirmed. Then, nothing mattered," she says.

Says Dr Khanna, practicing IVF specialist for last eight years, "Every single step (see box), right from taking out a woman's eggs to introducing the embryo into her womb is crucial. We just cannot afford any mistake."

And it is not just the procedural part that is important. Equally important is the counseling for both the husband and the wife.

Says Jana, a jewellary designer from Trilokpuri, who is expecting his first child this week, "The period immediately after the first cycle, which did not yield result, was bad. We were heartbroken, but counselling saw us through," he says.

With the cost ranging between Rs 60,000 to 2 lakh per cycle, everyone cannot afford treatment. Only two government hospitals - All India Institute of Medical Sciences and Maulana Azad Medical College - offer IVF services, which cost between Rs 30,000 to 50,000 per cycle.

"The easiest option remains having at least one child before 30 and if you have trouble conceiving after that age, visit an IVF specialist as early as possible," says Dr Khanna.

(Names of patients changed to protect their privacy)