Civic body starts to monitor maternal deaths during IVF

The Brihanmumbai Municipal Corporation (BMC) has started a separate category for maternal deaths during or two weeks after childbirth in cases of in vitro fertilization

The Brihanmumbai Municipal Corporation (BMC) has started a separate category for maternal deaths during or two weeks after childbirth in cases of in vitro fertilization (IVF). This is in response to an increase in the demand for assisted reproductive technology (ART) to help older couples achieve pregnancy, which can also lead to complications.

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Data from the BMC accessed by HT shows six IVF maternal deaths in the past five years in Mumbai – one death in 2015-16; three in 2018-19; and two this year. Two of the six deaths were of patients who came to the city for ART.

According to data accessed through a right to information (RTI) query, 32,864 women opted for IVF treatment in Mumbai between 2012 and 2016. In 2012, 3,961 patients underwent IVF which steadily rose to 8,313 in 2016.

IVF is one of the more widely used forms of ART in which medicines are used with surgical procedures to help the sperm fertilize an egg, following which one or more fertilized eggs are implanted in a woman’s uterus. Medical experts caution couples above the age of 40 against opting for IVF because of the high probability of developing co-morbid health issues such as hypertension, diabetes and cardiac ailments.

Doctors attributed factors such as changing lifestyle and the age of patients opting for IVF as among the causes for death.

“Records of all maternal mortality cases are studied and reports are submitted to higher authority for research and analysis. Adding IVF as a category will help understand if deaths are a result of the treatment or related to it. The civic body can accordingly develop policies to handle maternal mortality rates in Mumbai,” said Dr YS Nandanwar, former head of gynaecology unit, Sion Hospital.

“While it is an advanced form of treatment with low risk of mortality, health complications during [an IVF] pregnancy mostly affects patients above 40 years,” said Dr Nandita Palshetkar, president, Federation of Obstetric and Gynaecological Societies of India.

“The earlier the couples approach us, lesser the threat.”

Health experts have also raised concerns over lack of rules and regulations on conducting IVF on older couples. “When a woman opts for IVF, she is injected with hormones that have several side effects on health. In many cases, doctors don’t appropriately counsel couples on possible health implications they can develop later,” said Dr Anant Bhan, bioethics researcher, global health and policy.

“There is a larger question of medical ethics. Just because we have technology, it doesn’t mean we can use it randomly without any guidelines.”