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New Delhi: While
one-year-old Chirag takes small steps in the courtyard, his mother
Savita Bhati lies still with swollen legs on a cot at her
sprawling residence in west Delhi. Bedridden due to chronic
osteoporosis, Savita gave birth after 34 years of marriage through
in-vitro fertilisation (IVF) done at the age of 56.
She was never told about the dangers of undergoing the IVF
treatment at an age when she had neared menopause and become
vulnerable to many other age-related disorders.
"The private clinic I chose with my family had assured us of
results. Having stayed childless for so many years, nothing
sounded more important than having your own flesh and blood in the
cradle," Bhati, who underwent the IVF therapy at a private clinic
in Uttam Nagar, told IANS.
"At least I will not be known barren," she spoke as she struggled
to sit with a pillow behind her back.
For Bhati's family, the fact that it "has a heir is a blessing in
itself".
With the World Health Organisation (WHO) estimating that 13-19
million couples are infertile in India, IVF clinics have
mushroomed unhindered.
The deep-rooted stigma associated with childlessness makes some
clinics go all out, even if it means flouting Indian Council of
Medical Research (ICMR) guidelines on Assisted Reproductive
Techniques (ART), with some of them surviving on outdated
equipment and lack of skilled doctors.
Fertility experts say nothing can be done with the ICMR
guidelines, until the ART bill is introduced for strict
compliance.
"ICMR is just associated with formulating guidelines on
accreditation of IVF clinics. ART is a growing sector...If the
demand is there, people will seek private care," ICMR director
general Vishwa Mohan Katoch told IANS.
"I cannot comment on the regulation of mushrooming clinics because
it is not ICMR's job," Katoch added.
IVF, considered a form of ART, is used to conceive the child
outside the woman's body. The eggs and sperms are placed together
under controlled conditions for fertilisation, after which the
resulting embryos are placed back in the woman's uterus to
initiate pregnancy.
The 128-page ICMR national guidelines were given in 2005. But
these have drawn flak for want of a stringent licensing procedure
to open IVF clinics, other than failing to draw up any regulation
on the age of the woman undergoing IVF treatment and insufficient
monitoring of existing clinics.
"To open an IVF clinic, you need to get the certification needed
to open a general nursing home. Licensing of the ultrasound
machine is also needed because of the act banning sex
determination. The staff does not matter - you keep one or two
gynaecologists, have the basic infrastructure to give a hunky-dory
picture of the clinic," says Abha Majumdar, who heads the centre
of IVF and human reproduction at Sir Ganga Ram Hospital.
The cost of setting up a clinic runs up to Rs. 10 million. With
the cost of a single IVF treatment being around Rs.150,000, it is
not very difficult to recover the initial cost, Majumdar said. The
government-run centres charge around Rs.60,000.
The desperation and dreams come alive at hundreds of such clinics,
with many promising a success rate that is not practical, say
experts. The success rate of the treatment actually lies between
30 and 40 percent.
"The sad truth is that IVF centres are mushrooming so much that
there is no cap on the procedure, equipment, quality, regulation
on donor eggs, and the woman's health condition is also ignored at
times," Majumdar told IANS, adding there is no registry maintained
to tell the number of clinics.
The practices common at these clinics include the auction of donor
eggs for pregnancies among 45-plus women and repeated IVF cycles
in the name of achieving success - sometimes endangering the
woman's
life.
Sudha Prasad, IVF programme coordinator at the Maulana Azad
Medical College (MAMC), estimates there is a new clinic coming up
every 10 days. The MAMC centre, started in 2008, has done over 280
IVF procedures so far.
"Earlier it was a high-end treatment, but now even couples from
small towns are coming after taking loans. The reason is the
awareness and demand for the treatment," Prasad said.
The ART bill, which was approved by the health ministry and the
law ministry, is yet to be tabled in parliament. It presses for
stronger monitoring and regulatory measures for the clinics.
"We have the regulatory guidelines by ICMR. But in the absence of
law, they are toothless," she concluded.
(Madhulika Sonkar can be contacted at madhulika.s@ians.in)
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