‘Birth deffects tied to fertility techniques’
Risk 2 to 4 times More in Babies Born with Help Of Assisted Methods Than In infants conceived Naturally : Study
Infants conceived with techniques commonly used in fertility clinics are two to four times more likely to have certain birth defects than are infants conceived naturally, a new study has found.
The findings applied to single births only, not to twins or other multiples. The defects included heart problems, cleft lip, cleft palate and abnormalities in the esophaemia or rectum. But those conditions are rare to begin with, generally occurring no more than once in 700 births, so the overall risk was still low, even after the fertility treatments, Cleft lip, for instance, typically occurs in 1 in 950 births in the United States, and the study found that the risk about doubled, to approximately 1 in 425, among infants conceived with the fertility treatments.
The procedures that increased the risk were so-called assisted reproductive techniques, like in vitro fertilization, which require doctors and technicians to work with eggs and sperm outside the body. The study did not include women who only took fertility drugs and did not have procedures performed, “I think it is important for couples to consider the fact that there may be a risk for birth defects,” said Jennita Reefthuis, an epidemiologist at the Centers for Disease control and Prevention, and the first author of the study.
But Reefhuis (pronounced REEF-house) also said that although her study linked fertility procedures to birth defects, if did not prove the connection or explain it. If the connection is real, it is known whether the procedures increase the risk for birth defects, or whether infertility itself raises the risk.
Fertility doctors, she said, “may not believe my findings.”
James Grifo, director of the fertility clinic at New York University Medical Center, said, “the good news is that there risk is low.”
Grigo said more research was needed o test the findings because the study included only 281 women who had fertility procedures. He did that if the association with birth defects was real, the underlying cause was more likely related to the patients infertility than to the treatments.
Twins and other multiple births have a higher risk of birth defects than single births and whether infertility treatment adds to that risk is unknown.
Alan Fleischman, vice—president and medical director of the March of Dimes, said: “I think it’s an important study. It’s confirmatory of the direction we have been concerned about, an increase in some structural birth defects in babies born with assisted reproductive techniques compared to those born with assisted reproductive techniques compared to those born with assisted reproductive techniques compared to those born without such. And yet the numbers are still small, the risks are low”.
Women considering fertility treatment should be informed that there might be a informed that there might be a risk of birth defects, Fleischman said, but they need not be ‘overly concerned”.
Country’s first frozen egg baby born in Chennai hospital
Bonnie boy pre-term, yet doing well at 2.5 Kg
CHENNAI: when oocyte (egg), --- life is created. For – a 29 year-old mother, life was created when donor oocyte met sperm in a laboratory in G.G.Hospital here. The result was the country’s first frozen egg baby, a bonnie boy, pre-term, yet doing well at 2.5 Kg.
In a planned Caesarean procedure conducted by kamala Selvaraj and Priya Selvaraj and Priya Selvaraj on Wednesday morning, the yet-to be-named baby boy carried gustily as doctors pulled him out. He was transferred to the nursery for observation where he continued to do well.
When geneticists told Ms. V, who prefers to remain and famous that her chromosomes abnormality was coming on the way of realizing her domain of holding her own baby in her arms, it strangely cleared the path for future action.
As Ms. V’s chromosomal defect would render any pregnancy unstable, and any baby so formed abnormal, it was clear that she needed a donor egg. It was with this request that she made her way to G.G. Hospital.
“ In a way it was good that the geneticist had clarified things for her. By the time she came, there was just one option—of using a frozen donor egg along with the husband’s sperm,’ says Priya, Selvaraj, who treated Ms. V. The egg, cryopreserved, or stored frozen at sub Zero temperatures, would be thawed, and using the Intra Cytoplasmic Sperm injection procedure integrated with the sperm.
“There is so much architecture inside the egg---it carries the entire chromosomal spindle. That makes it difficult to freeze, store and thaw, especially achieve fertilization,” Dr. Priya said, Studies in peer-reviewed journals indicate that the mean survival rate of a harvested egg is about percent, the fertilisation rate is 52.5 e cent, the mean pregnancy rate is 1.52 percent and chances of a successful delivery about 2 percent. “ It is not much, even in the area of s reproduction techniques. But, in such cases, where there is no other hope for the woman, we go ahead,” she added.
It was decided to use an egg frozen for six months on Ms. V, as her own eggs could not be used. Led by Dr. Priya, the team, which included S. kalaichelvi, conducted the procedure through the slow freezing method. Two women went in for embryo transfer and it was M.s. V, hailing from Tamil Nadu, who turned out to be the one with all the luck. Part of that luck, she seems to have parceled into a gene gift for her new born son, a gift that, undoubtedly, will serve him well.
As India debates the Nikita Mehta judgment….
Mumbai docs want to try alternative therapy to ensure healthy babies.
EVEN as the HC denied Nikita Mehta permission to abort her 25-week-old foetus, two Mumbai doctors are hoping to use alternative therapy that will ensure healthy babies. This treatment can be used when allopathic medicines fail to provide the desired results.
Dr. H S Palep of integrative medicine and Dr. Geeta Niyogi of obstetrics, head of their respective departments at K J Somaiya Medical college, are in talks with the Boston University of Medicine to rest the success of an ayurvedic drug on 300 pregnant women aged 18-44 for healthy babies. The drug called Sujat (See box) claims to strengthen the placenta that supports the foetus.
The research will follow a ‘double-blind system where a placebo will be given to 150 expectant mothers and Sujat to the rest. The women will then be tracked for the entire term of their pregnancy.
“The average birth weight for an Indian is unable to significantly raise this weight, why, not try alternative medicine,” said palep who proposed the same to Dr. Robert Saper of Boston University last year.
The initial reaction was skeptical. “Alternative medicine is an important part of the course for medical students in USA, while in India it’s virtually ignored,” said Palap. The investigators are now waiting for approval from the Indian Council of medical Research and Us NIH/NICHD health authorities to start research.
What is Sujat?
A combination of nine different ayurvedic ingredients designed to strengthen the placenta of an expecting mother and improve general health.
SEEDING TROUBLE ? CHECK AGAIN
Despite WHO’s updated Reference Range, Most Labs In the City Are Using The Old Criteria for Sperm Count Analysis
TESTING TRUTHS
? One only needs a license under the shop and establishment Act to set up a diagnostic laboratory.
? The need for standarisation and quality management in diagnostic labs was highlighted by the death of union minister P.R. kumaramangalm in 2000, allegedly due to misdiagnosis.
? This promoted the Union health ministry to ask state governments to introduce regulatory and quality control mechanisms in the healthcare sector
? The state government responded with the Maharashtra Clinical Establishments Bill 2001 to regulate nursing homes, Bill 2001 to regulate nursing homes, hospitals and pathology laboratories.
? A draft of this legislation is awaiting approval of the law and judiciary department
? The Union government also assigned the national accreditation Board For Testing and calibration Laboratories (NABL) with the task of auditing diagnostic labs. But these audits are voluntary.
? Pathologists and consumer organisations had opposed a 1998 regulatory proposal to control pathology laboratories
COUNTING MISTAKE
? Normal sperm count as set by the WHO is 20 million/Ml and above
? But the range followed by a large number of labs in the city is 40 million/ml to 120 million.
? Most of these private labs use Neubars Chamber or Meckler chambers to assess the semen count.
? Ideally, these tests should be done at centres with computer assisted sperm analysis (CASA)
? But there are no labs in the city with CASA.
? Moreover, there are only two accredited path labs in the city.
What is low sperm count?
If a sample has less than 20 million sperm per ml, it is considered as low sperm count. Less than 10 million is very low and the technical term for this condition is oligospermia (oligo means few).
Azoospermics are those with no sperm at all. This can come as a rude shock to these patients as their semen look absolutely normal, but it is only on microscopic examination that the problem is detected.
Is just one test enough?
If the sperm test is abnormal, atleast 3-4 tests over a period of 3-6 months are required to confirm whether the abnormality is persistent or not. So don’t jump into conclusions based on just one report. The sperm counts also do tend to vary on their own. It takes six weeks for the testes to produce a new sperm which is why you need to wait before repeating the test. It also makes sense to go to different laboratory for the next test to ensure that the diagnosis is correct.
`
What leads to incorrect semen analysis?
? Incorrect collection technique
? Too much time between collecting the sample and testing
? A short interval since the previous ejaculation
? Illness in the last 3 months (even a flu or a fever can temporarily depress the count)
You can now shop for sperms in city.
Firm From Denmark Sets Up Branch in Mulund.
Mumbai: When infertility specialists across the globe are worried about the falling number of sperm donors, an international sperm bank has set up a branch in Mulund with- in a year, the bank will start selling samples to infertility doctors across the country.
The reason behind Denmark-based Cryos International starting its Indian operations is simple: huge business potential. Its MD Dilip Patil said, ”IVF specialists said there was a need for good quality donor sperm.”
Dr Pushpa Mitra Bhargava is a member of the Indian council for Medical Research (ICMR), the committee ----- the guidelines for fertility clinics, look at things more scientifically. “When the new Act on infertility clinics come into force, it will be mandatory to have anonymous donors instead of the current practice of directed donation of sperm (the donor or recipient are decided beforehand),”said the scientist. “Then, this sperm bank-the second stand-alone facility in Maharashtra after the one in Aurangabad –and many more will become al, the more popular.”
At present, most infertility clinics have their own sperm banks for patients admitted there. None of them sells sperm to outsiders. However, the new Act will make it compulsory to have individual sperm banks, separate from fertility clinics. “If a person owns an infertility clinic, he cannot operate a sperm bank there, ”said Dr. Bhargava.
Dr. Anirudda Malpani who runs of clinic in Colaba, said the only difference between the two is that the new facilities “are willing to sell samples to gynacelogists and clinics, while now, infertility specialists operate captive sperm banks that cater only to their patients.
WHY SPERM DONATION IS NOT EASY
It’s difficult to get sperm donors mainly because of the lack of awareness. “Moreover, donating blood. A person has to make donations 10 times and each time, he is paid between Rs 500 and Rs 1,000. There is a series of tests that have to be conducted such as HIV and sperm quality tests,” says Dr. Aniruddha Malpani.
US clinic lets parents pick baby’s eye, hair colour.
A clinic in Los Angeles is offering the ultimate in designer babies. Want a son with brown eyes, back hair and a dark complexion? Or a pale-skinned, blonde, green-eyed daughter?
The Fertility Institutes clinic is offering prospective parents the opportunity to select physical traits of future offspring thanks to “cosmetic medicine”, reports the Telegraph. But other fertility experts are outraged that the clinic is seeking to capitalise on dramatic advances in embryo cell analysis designed to identify dangerous disease and defects in the unborn.
They are angered that the bespoke baby in vitro fertilisation service is distracting public attention from how the pioneering medical technology can have children free of debilitating genetic conditions, who as a young medic was part of the team involved in the birth in Britain in 1978 of Louise Brown, the world’s first test tube baby, is undeterred.
Steinberg’s clinic has received “five or six” requests for the new service which involves embryo selection, not genetic modification. The groundbreaking science is based on a procedure known as pre-implantation genetic diagnosis (PGD) that for years has allowed doctors to identify potentially lethal disease and conditions in embryos.
Infertility can be a shattering experience for any couple Dr. KAMINI A RAO lists some of the myths associated with the problem and presents the facts.
Fact: masturbation is a normal activity which most boys and men indulge in. It does not affect the sperm count. Sperms are constantly being produced in the tests, therefore earlier sexual activity does not affect the sperm count. However the sperm count can be affected by other factors including environmental factors, alcohol , smoking etc.
Myth: You need to relax and stop thinking about your problem. You are too stressed out to get pregnant.
Fact: infertility causes stress-stress does not cause infertility. Infertility is a medical condition, a disorder to the reproductive system. While relaxing may help you cope with the overall problem, the stress and deep emotions you feel are the result of infertility and definitely not the cause for it.
Myth: Painful periods cause infertility.
Fact: Painful periods do not affect fertility. In fact, for most patients, regular painful periods usually are a sign of ovulatory cycles which, in fact, is a sign of fertility. However , progressively worsening pain during periods may indicate endometriosis a condition which can be a cause of infertility.
Myth: We have our entire lifetime e to have a baby. Right now career comes first.
Fact: This is a fast emerging trend in today’s world with a majority of couples postponing conception due to demanding careers.
Unfortunately, unlike their male counterparts, here are certain boundaries for women when it comes to reproduction. The unfortunate fact is that fertility does decline with age, and there no treatments available that can” turn back the clock” on a woman’s ovaries.
The only consistently successful method to improve pregnancy rates in women with age-related (or “elevated FSH-related”) infertility is egg donation. Some indications for egg donation include advanced age, persistently high FSH levels at any age, poor response to fertility medications at any age, and poor quality embryos at in vitro fertilization.
Myth: Pregnancy will occur if you just give it enough time.
Fact: A certain time period should be given for conception to occur but if pregnancy does not occur after 12 months of unprotected intercourse, couples should seek consultation with an infertility specialist. For couples over 35 years of age, it should be after six months.
Myth: If you have already had one child you cannot be infertile.
Fact: Secondary infertility (Difficulty in conceiving in spite of having one child) is almost as common as primary infertility. Unfortunately for many couples who have a child and wish to conceive again, a variety of factors can contribute to infertility. A number of changes could have occurred or problems could have cropped up, since the last conception.
Myth: Maybe you two aren’t mean to be parents’
Fact: Remember, that infertility is a medical condition, not God’s will.
Myth: The pill causes infertility
Fact: There is no connection between fertility problems and using the Pill for any length of time. This is amply justified by the number of women who have landed up pregnant because they forgot to take their pill. A person who has infertility problems before going on the pill; will have them after stopping it.
Myth: A man’s sperm count will be the same each time it is examined.
Fact: A man’s sperm countvaries from time to time. Sperm number and motility can be affected by time between ejaculations, illness, and medications. Lifestyle changes---such as quilting smoking, losing weight, and staying out of hot tubs-may also help
Myth: I cannot take time off from infertility treatments for any reason…. This month may just be “THE one!
Fact: Continuity in treatment is important, but sometimes a brake can provide needed rest and renewal for the next steps.
Myth: A man can judge his fertility by the thickness and volume of his semen.
Fact: The volume and consistency of the semen is not related to its fertility potential which depends upon the sperm count . This can only be assessed by microscopic examination.
Myth: I cannot afforded to ask too many questions. It may irritate the doctor.
Fact: The physician /patient team is important. You need to be informed about what treatments are available. What is right for one couple may not be right for another. Don’t be afraid to ask questions of your doctor. A second opinion can also be helpful. If needed, discuss this option with your physician.
Myth: Incompatibility of blood groups between husband and wife can cause infertility.
Fact: There is no relation between blood groups and fertility.
Myth: Infertility is nature’s way of controlling population.
Fact: Even over populated countries allow for couples to replace themselves with two children. Individuals or couples can certainly elect the option to be childfree or to raise a single child. For those who desire children, infertility, denies them the opportunity to choose.
B’lore couple get baby through IVM
BANGALORE:
Infertility treatment techniques took another successful step in took another successful step in the country with the birth of a healthy child through invitro Maturation of immature oocytes, at the Gunasheela Surgical and Maternity Hospital in the city, on Thursday.
The baby boy was born to a Bangalore-based couple who had been childless seven years into their marriage.
Invitro maturation (IVM)of immature occytes is a relatively new technique beneficial especially for women with polycystic ovarian syndrome and normally fertile women whose male partners have infertility problems The world over only some 250 children are known to have born of this technique.
The process of IVM involves the removal of immature eggs from a woman’s ovaries and maturing them in hormones and her blood in a laboratory dish for 24 to 36 hours.
The eggs are then fertilized by direct sperm injection and the resulting embryos are implanted in the womb.
Since the ovaries are only partially stimulated in the IVM technique, it reduces the risk of Ovarian Hyper-stimulation Syndrome, a condition for which women me are the most prone to. Drugs wise the treatment also works out cheaper as drugs used to stimulate the ovaries are drastically reduced.
The medical team at the Gunasheela IVF Centre was led by its Scientific Director Dr. Sulochana Gunasheela and Embryologist Dr. Varsha Samson Roy. The later is trained in Clinical Embryology from the Singapore national University. Both note that IVM births have not been reported in India earlier.
The clinic began its work on the couple in this particular case in August last and succeeded in ‘Ova Maturation’ in November. Success came after’13 failed attempts’, notes Dr. Varsha Roy.
Dr Sulochana revealed that the clinic is awaiting the birth of two more children also convinced through IVM “Both the women are into normal pregnancies now and they are due in five months time”, she said.
Hope for infertile women
Successful womb transplants could be carried out within two years, according to a leading British Surgeon.
HOW THE PROCEDURE WORKS
? Healthy womb transplanted from decreased woman, with large blood vessels intact
? Recipient given drugs to stop her body rejecting new womb
? She attempts to conceive naturally if possible or, more likely, through IVF
? Baby delivered by caesarean section as transplanted tissue unlikely to withstand natural delivery.
? New womb can only be kept for a maximum of two to three years.
? It is then removed in a hysterectomy damage if taken any longer
Made in 2007, born in 2010
US Couple Ship Frozen Embryo All The Way To India, Get Bundle Of Joy Through Surrogate Mother
Legal Sanction To Surrogacy
? India permits commercial surrogacy according to which a woman is paid to carry a child to the term in her womb, The Indian council for medical Research has laid down the guidelines for commercial surrogacy, The Supreme court too has upheld the legality of commercial surrogacy in the Manji case
? The surrogate usually has to be a mother already, said Dr. Yashodhara of Surrogacyindia
? The Surrogate usually has to be a mother already, said Dr. Yashodhara of Surrogacyindia
? The payment is made to the surrogate mother according a contract signed in which there is carry the child to the term and hen hand over the child to the intened parents.
? The surrogacy agreement is an important document and it includes the payment mopdule between the intended parents and the surrogate mother .it demarcates the liability of the surrogate and intended couple are required to sign the surrogacy agreement after clearly understanding the contents of the agreement.
? The agreement will clearly state that the surrogate does not intend on parenting any resulting children and does not wish tp have physical or legal custody of any resulting children. The surrogacy agreement will also define the rights and responsibilities of the assisted parents.
Day after HC Ruling, Anxious couples in City Rush To Seek Expert Advice
Doc, Will my baby be normal?
TESTING TIME
In Mumbai, many would-be parents have access to a range of tests to detect genetic abnormalities in their unborn babies. These tests include:
Dual Marker (11-13 weeks) Triple AAA marker (16-18 weeks) Beta-HCG Test Nuchal Cord Translucent C test (9-13 weeks) 3D or $D Anomaly Scan (20 weeks) Foetal Echocardiography (20-24 weeks)
If the results of the screening tests turn up positive, a host of invasive tests can confirm the genetic abnormalities. These tests include Amniocentesis (16-18 weeks), CVS ((-12 weeks), Foetoscopy and foetal Blood Sampling
I have lost strength but I know I must accept what god has in store for me. My baby , despite its ailments, is now the joy I look forward to
Couple wants another child
• IVF clinics use the parent’s gametes(eggs and sperm) to produce embryos in laboratory. The embryos are then transferred to the genetic mother’s or surrogate mother’s womb. As many embryos are produced in one go, parents have the option of freezing the embryos for use at a later date, say three to five years down the line.
• There is no evidence that babies born from frozen embryo transfer have any increased incidence of congenital abnormality.
• However, there are several ethical and moral issues related to human embryo freezing:
• FATE: of the stored embryos
• OWNERSHIP of the embryos if the couple divorce
• SAFETY of embryo freezing
• PERIOD for which embryos have been kept in storage may have a detrimental effect on the outcome of frozen embryo transfer and possible increase in fetal abnormalities. However, no long-term studies have been carried out. In addition, there is no evidence that extended storage is detrimental to the outcome of treatment
• Embryos can be frozen at any stage if they are of good quality. They are stored in batches of one or more, depending on the number of embryos that are likely to be transferred into the uterus at a later date
• Embryos are put into a fluid meant to protect them from damage during the freezing process. Then, it is put either in a glass ampoule and stored in liquid nitrogen at a very low temperature(-1% degrees C).
• Different countries have different regulation concerning the period for which embryos can be frozen. In the UK embryos can be stored for a maximum of 10 yrs.
1 child dies every 15 seconds in India.
NO KIDDING
Over 20% of the world’s child deaths occur in India
20 lakh children die before reaching their fifth birthday.
One in three malnourished children in the world lives in India.
Around 46% of Indian children under 3 years are underweight.
India’s record on newborns (72 per 1,000 live births) and child morality worse than Bangladesh and Sri Lanka.
Exercising in pregnancy boosts baby’s IQ
Burning Fat While Expecting And 9 months Of Breastfeeding Make A Clever Child, Say Experts
Mothers who exercise during pregnancy are helping to boost their child’s IQ according to re-search by American psychologists.
In a challenge to the conventional, wisdom that intelligence is 80% inherited, Richi--- Nisbett, a psychologists and fathers of two, argues that recent findings point to a pivotal role for mothers. Fathers, weather absent or doting, have relatively little influence over their offspring’s intelligence.
In a new book, ’Intelligence and How To Get it’, NIsbett highlights the important part the mother plays I shaping her children’s ability to learn and reason starting shortly after conception. “Children whose mother exercised 30 minutes a day score around eight points higher on standard IQ tests than children whose mothers were more sedentary,” he said last week. “ breastfeeding for up to nine months may increase IQ by as much as six points. “
{previous generations of mothers were encouraged to avoid doing much exercise after the first three months of pregnancy . The latest research suggests that using light weights, stretching and even running can be beneficial to some, through not all.
Official advice in Britain is that the more active and fit most women are during pregnancy, the more easily they will adapt to their changing shape and weight gain. It will also help them to
FEEDING INTELLEGENECE:
Fathers, whether absent or doting, have relatively little influence over their offspring’s intelligence, say researchers cope with abour. “ Exercising large muscle groups increases the growth of neurons and adds to the blood supply of the brain, “ writes Nisbett. Exercise and breastfeeding combined, he says, will raise a typical child’s IQ to about 114, 14 points above average.
Nisbett also argues that the way mothers talk to their children can help to increase their IQ. He encourages parents to ask questions to which they already know the answers and, if necessary, explain how the, how they know to seek answers to their won questions.
Nisbett praises middle-class families in particular for setting what he calls “anticipation exercise “, in which children are asked to make predications, such as where a submerged duck will surface in a pond. He also says that children who successfully complete a task should be praised for their hard work rather than be called clever, because hard work is something over which they have control.
His ideas are catching on. In Texas, mothers are being taught how to create an” educationally rich” atmosphere at home for their children, especially during the summer holidays, Nisbett says the choice of school also helps. He praises Kipp, or Knowledge Is Power , the fast expanding private school chain in the United states, which trains poor urban children and their mothers to study 12 hours day and take only short holidays Kipp IQ scores match those of expensive private schools.
Wombs for rent
For the production and delivery of a child, women in
Anand earn $ 5,oo0 to $7,000
Outsourcing parenthood, American-style
None of that yucky nappy-changing for you? Learn how they do it in New York, “the leading edge of parental avoidance”, reports New York magazine. Here’s a hands-free guide to rearing a child-all for a price of course you can hire someone to…
HAVE THE BABY FOR YOU
Cost:$80,000. Paid surrogacy is illegal in New York state, but agencies help you find a vacant uterus elsewhere. Cost includes lawyers’ fees, hospital visits your surrogate’s shrink appointments, maternity clothes, ice cream to slake her pregnancy cravings, and a weekly stipend should she wind up on bed rest.
BURP HER
Cost: $4,300. Chicago-based thumb-sucking guru Shari E Green claims she can kick your kid’s habit in two sessions.
RAISE HER
Cost: $1,200 a week for live-in nanny plus a 15% fee for placement agency. (For a fill-in on weekends add 48 hours of babysitting at $15 an hour.)
THROW HER A B’DAY PARTY
Cost :$825 for 25 kids for a4 hours. You won’t have to lift a finger---or show up.
BUY HER GIFTS
Cost: Free. Personal shoppers of big toy stores like FAQ Schwarz do it for you.
IMPART GOOD BREEDING
Cost: For $200 an hour, image consultants help your teen with etiquette lesson, personal shopping, style guidance;
POTTY-TRAIN Cost $3,700. Sends a live-in instructor to your home for two weeks
STOP HER SCREAMING AT NIGHT
Cost: $350 for a five-day plan by sleep consultants
Water births a fad in India
New Delhi: Women who have opted for water births have given their thumbs-up to the mode of delivery. Although even experts have lauded it coming in the wake of rising c-section cases, only two or three Indian cities offer water births.
In Delhi, the number of C-section deliveries have shot up from 40% in 1997 to 65% of all births, despite a WHO advisory they should not exceed 15% in any society. A birthing centre in Goa, set up by Corinna stahlhofen from Germany, was among the first in India to offer water birth. It was introduced in Delhi’s Phoenix Hospital in May this year. Though it costs 5-10% more than a normal delivery, the hospital hasn’t exactly seen women quench up for delivering in water. Hiranandani hospital in Powai, Mumbai, recently introduced an LDRP (labour, delivery, recovery pueperium rooms)which offers the option of water births. “We use a water tub for labour pain relief. When the patient is ready for delivery, we shift Anita Soni, consultant gynecologist at the hospital.
Says Dr. Urvashi Sehgal, a gynecologist in Phoenix, who has delivered over half-a-dozsen babaies in water, “It will take time to catch on here as people are not aware of it.”Another are not aware of it.” Another advantage of water births is in managing pain. “Pain is relatively easier to handle in warm water though the process is not entirely painless,” says Sehgal “Water births will soon be a fad, particularly among the rich and the expat community here,” says Anuradha Kapoor a gynecologist at max Health care. However, they are not without potential risks, thought there is little documented evidence on perinatal morbidly and mortality. “Delivering babies in water is difficult. The real danger is the baby can get asphyxiated in water, ”says Dr Kapoor.
Underwater births have time and again reared controversies, with a school of thought believing it could lead to complications for the newborn, says Soni. Dr. Vanika Prim of Fortis Healthcare feels the new method started off well but hasn’t yet to proved to be effective,.”It is difficult to monitor the patient’s heart beat if she is in water,” she says.
Commercial Surgery legal, says SC
Allows Manji’s Grandum To Seek Docus From Govt For Japan Return
Delhi: Japanese surrogate baby Manji may have thrown up a huge debate about the ethicality of surrogacy, but the Supreme Court not only validated” commercial surrogacy”, it also termed it a virtual industry in India.
In its judgment in the Manji case on Monday, the apex court allowed the child’s biological grandmother to approach the Centre for travel documents to fly back to Japan, but at the same time put its stamp of approval on’ commercial surrogacy’.
A bench said in commercial surrogacy, a gestational carrier was paid to carry the child to maturity in her womb and was usually resorted to by couples to complete their dream of being parents, “This medical procedure is legal in several countries, including India, Where due to excellent medical infrastructure, high international demand and ready availability of poor surrogates, it is reaching industry proportions, ”the bench observed.
And this precisely the apprehension expressed by NGO Satya, which through advocate, Abhinav Sharma, argued that the absence of law has left such an important social and emotional field open to abuse by middlemen, who are increasingly being approached by rich foreign couples to arrange for poor surrogates.
Appearing for the child’s grandmother, senior advocate Indiara Jaising had argued that as long as surrogacy -----expressly banned by----it could be not termed illegal moreover, an NGO could not have the locus standi to interfere in a matter that squarely fell on the surrogate and the biological father.
The apex court, without deciding the locus standi of the NGO, said the commissions set up at the state and national level under the Protection of child Rights Act, 2005, were competent to look into the rights of a surrogate child.
However, before parting with the case, it discussed in detail with the origin of the concept and types origin of the concept and types of surrogacy-traditional, gestational, altruistic and commercial.
The bench did not forget to mention the offensive terms often used to describe” commercial surrogacy as “wombs for rent”, baby farms” it was also aware that in compensated surrogacies the amount a surrogate receives vary widely from reimbursement of maternity expenses to over $30,000.
Normal delivery possible after caesarean op: docs
HOPE AFTER
C-SEC
WHAT IS VBAC
Vaginal Birth After caesarean (VBAC). Contrary to popular perception that if the first delivery is through if the first delivery is through c-section, the second will be too, it is possible for women to have a normal delivery even after a caesarean.
HOW COMMON IS IT
Gynecologists say that there is a 50 per cent chance of a woman delivering normally afte caesarean, provided the reason for the previous caesarean are not present during the second delivery
WHAT AIDS IT
• There was a low transverse incision on the uterus during previous caesarean delivery
• There are few caesarean delivers before a normal delivery
• The reasons of previous caesarean section are not present in the current pregnancy.
• If the uterus scar is thick and chances of rupture are less .
• A normal delivery for the second child , after the first was born through cases are an section , is not impossible, say leading doctors.
WHAT HAMPERS IT
• The pelvis is small
• The placenta is not low lying
• The baby’s head is upside down.
ADVANTAGES
• Quick recovery
• Baby less likely to have breathing difficulties
• Chances of placenta lying at the opening of the uterus in future pregnancies is less
DISADVANCTAGES
• Chance of uterus ruptures are high
PRECUATIONS TO BE TAKEN
• It’s important to have well-toned pelvic muscles
• Breathing exercises
• A balanced diet.
The success rate of a normal ---very after a caesarean depends on the woman’s medical condition, but experts say chances are as high as 50%. While recurrent obstacles include small pelvis, non-recurrent causes comprise mother’s BP & low-lying placenta
US Woman’s Mumbai miracle
JOY’S BUNDLE OF JOY
What is Cervical Cancer
Cervical cancer is an abnormal growth of cancer cells in the opening of the uterus connected to the upper vagina, known as the neck of the uterus.
The Problem Joy was diagnosed with cervical cancer in 1992 at the age of 21, so her uterus had to be removed, but ovaries were pushed up into her abdominal cavity.
Procedure The couple Underwent
• In December 2008, Joy and Kelly came to Mumbai, chose a surrogate mother, signed the papers and four eggs were taken from her and planted in the uterus of Rekha. But the procedure was not successful.
• This March, the couple returned and repeated the procedure. This time, only one egg was formed, resulting in one embryo. This embryo was successfully plated and fertilized in Rekha’s womb.
• The couple returned to India on November 23 for the delivery. The baby was born November 24
• Any information about to India clients and donors must be kept confidential, except, with the person’s (to whom the information is related) consent.
• All relevant information must be given to the patient before the treatment is started.
• No treatment should be given without the written consent of the couple to all the possible stages of the treatment.
• People seeking registered treatment must be given counseling.
• No more than three embryos must be placed in a woman in any one cycle.
• Highest possible standards in the storage and handling of gametes and embryos in respect to their security, recording and identification, should be followed..
What is In Vitro Fertilisation
In vitro fertilization is when the eggs from a woman and a sperm of a man are taken and infused together. An embryo thus surrogate mother. The woman may or may not become pregnant with the embryo. Generally, 10-15 eggs of a woman are retrieved and 2-3 embryos are planted in the uterus of the surrogate mother.
Childless NRIs home in for cheaper embryos
AHMEDABAD: In London, Suresh Patel could have become a father only after eight years, if at all. He was informed by the authorities at the local state-run hospital that the queue for childless couples opting for in vitro fertilization (IVF) or a test-tube baby was too long and it would be at least eight years before he his turn came .
Suresh and his wife Payal, both already on the wrong side of 40, didn’t want to wait that long, So, they decided to take a fight back home to Ahmadabad and within 20 days are already on the first cycle of their IVF treatment!
“It’s cool, No waiting, good doctors, better facilities and best rates, what else can you ask for, ”quips Suresh who is all set to mix business with pleasure as he readies to pack off to Goa for a mini-vacation. Not to forget that getting treatment in his home-town gave him and his wife the rare opportunity to enjoy Uttarayan too!
Suresh and Payal are not alone. Infertility specialists concede that the lure of getting treatment on a par with developed countries at a quarter of the price (air fare inclusive), with the added advantage of being amidst their near and dear ones, is primping more and more childless NRI couples to fly black home to fly back home.
From September-March, it is actually the ‘NRI season’ at the local infertility clinics! “Right now, there are eight NRI couples under IVF-treatment at our centre Otherwise too, the average is 2-3 patients every month,” says Dr. Manish banker of an IVF centre in Ahmadabad.
“Long waiting period in case the treatment is to be covered under the paid health plan is a big deterrent. If couples, costs could be exorbitant at anywhere between $ 10,,000-12,000(approximately Rs. 4.8-5.6 lakhs). While the best treatment here costs only Rs. 1 lakh per cycle,” explains Dr. Himnashu Bavishi.
There are factors beyond the high cost too. For many NRI couples, getting treated by a doctor speaking their own language can be a big advantage. Take couple was not comfortable taking treatment from a Chinese doctor.”The doctor was very good but we were just not comfortable. Moreover, the doctors there are very professional, while here the approach is more humanitarian, “feels Neela.
“I’m 42 years old and was prescribed egg donation by the local doctors in North Carolina. We waited for an Indian egg donor for three years… but no luck. Then somebody told us about going to Ahmadabad. Here everything was arranged in a month. I got the embryo transferred a week back and am hoping for the best,” says Raginiben Pandya, who is currently putting up at her home-town in Jamnagar.
It needs mention here that while there is a standard fee of $5,000 for donor egg in the US, the same here are made available at Rs 20,000! “Otherwise too, in developed countries there are strict regulations for selection of patients and other IVF-related issues. While here the things are largely unregulated,”concedes Dr. Banker.
No blond babies please, we’re Indian
The biggest problem of all for childless couples abroad is get hold of ethnic egg donors. “In most women above 35, the quality of eggs produced is not good enough and they have to go for donor eggs from younger women. Finding Indian donors could be a real problem for couples who obviously don’t want children with foreign characteristics like blond hair and blue eyes,” says Dr. Kantiben Bansal of a local fertility clinic.
Desi patients too need IVF techniques
Mumbai: An infertility clinic in Co-laba has successfully developed a low-cost and affordable IVF technique that brings down the cost of a test-tube baby to just Rs.25,000
“The entire contraption for offering I fertility treatment can this be produced at Rs.3 lakh, with its centerpiece a microscope to view embryos before the best few are placed in the mother’s womb.”Even district hospitals can set up a basic IVF service for young women whose reproductive facts have been destroyed by say tuberclusosis,” Dr. Aniruddha Malpani said.
Dr. Allahabadia of the Deccan clinic has adopted a different route to infertility treatment. The clinic, he said, is an attempt to realise his dead mother’s dream of taking IVF to the poor. “I have another clinic in Bandra . With some donations from friends and former patients as well as with some cross-subsidy mechanism between the two clinics, I offer the same IVF techniques available at posh clinics at less than half the rate,” said the doctor who offers a package of Rs. 40,000 including expensive medications. For the simplest infertility treatment called IUI. Deccan charges Rs 1,000 while it costs Rs.9,000 in other clinics. Around 200 patients have walked into the clinic for treatments in the last four months.
After years of catering to foreigners on the lookout for comparatively cheaper reproductive tourism,Indian infertility specialists seem to have woken up to the fact that desi patients too need low-cost IVF has in itself created a debate across the world, with experts wondering whether to offer sophisticated (read expensive) treatment with better pregnancy rates to patients or to offer affordable treatment with lower pregnancy rates.
Dr. Aniruddha malpani conceded that their new technique—which was devised in Germany in the eighties and called the Intra Vaginal culture (IVC)--- has a flipside in that it offers a lower success rate. “Because cost is the main concern here, we don’t advise patients to take expensive injections to stimulate more eggs. The patient may only have to take a few tablets, which cost less than RS. 100. But fewer eggs mean fewer embryos and hence a lower chance at pregnancy of around 20% success rate,” he said. .
Infertility specialist Dr. H Pai From Lilavati Hospital said, ”The intra-vaginal culture technique offered by the Malpanis is not as good as the standard IVF techniques, which offer up to 50% pregnancy rate in women who are lesser than 35 in the US.” He said couples should be offered the same success rate as standard IVF. Another expert said the intra-vaginal culture technique was given up because of poor results.
Now, test-tube babies at half rate
Mumbai: In the lane opposite Sena Bhavan, stands the Deccan Infertility Clinic, promising low-cost treatment just like a namesake airline offered cheap air travel until some time back. “Patients now need-n’t spend a lakh of rupees for a chance at having a baby,” claims Dr. Gautam Allhabadia from the new Dadar clinic.
On Friday, doctors from the Malpani Infertility Clinic Colaba announced a low-cost technique that they said could bring down the cost of a ‘test-tube baby’ to Rs 25,000. “This method can be replicated across the public hospitals and offer hope to thousands to infertile couples, ”said Dr. Anjali and Aniruddha Malpani.
With is fancy tags of IUI, IVF or ICSI, infertility treatment had hitherto seemed the domain of rich patients who could afford the Rs 1-lakh-plus tag despite the success rate of less than 40%. Considering that 15% of Indians in the productive age are infertile, the majority have never been able to try IVF. This could change with affordable IVF emerging as the new buzzword, although there’s no shortage of skeptics.
While the Malpanis have used technology to cut the price tag, Dr. Allahbadia has used cross-subsidy to fuel his dream. A senior doctor who doesn’t want to be identified, however, said, ”Affordable should not mean it is a compromise for the poor patients’ changes at pregnancy.”
` The Malpanis have done away with using the expensive carbon-dioxide incubator (for 7 lakh and is expensive to maintain. “ The eggs and sperm are kept in a plastic vial costing Rs.2. Instead of storing the vial in the expensive incubator, we are using a local hot block costing Rs.15,000 to maintain in the mixture’s temperature at 30 degree, centigrade,” explained Dr. Anjali Malpani. Alternatively, the vial can be stored in the mother-to-be’s vagina for two days using a female condom to keep it in place.”The vagina acts as an incubator,” she added.
Super baby: Guara
Us is clamoring for the made-in-India Ayurvedic miracle drug
The world’s biggest super power is craving for ‘super babies’. And for the magic potion, the US has turned to India.
Ayurveda offers a dream’ drug called Sujat, which, doctors say, will not only ensure an easy pregnancy, but also deliver a baby “much superior in terms of medical and physical health.
Sujat has been available in the Indian market for the past 12 years. Recently doctors at National Institution of Health, in Bethesda, Maryland, have shown interest in the drug seeking to conduct a collaborative clinical trial.
Gynecologist Dr. HS Palen-one of the brains behind the drug-confirmed that he was planning a joint study with researchers from Boston University Medical School to clinically prove the efficacy of the drug and its miraculous prosperities.
“Ayurveda has this concept of ‘super baby’ for ages. It can be attained when today with a fine mix of modern medicines,” said Palep, a practicing gynecologist also trained in Ayurveda. “This drug (Sujat) is administered on the mother from the time of conception till the baby is delivered, and can be continued throughout the lactating period.”
“Allopathy drugs miss out on micro-nutrients, which are essential for fetal birth weight and eventual growth,” he added.
Detailed experimentations with the drug at St Geroge and the KEM hospitals have proved that it significantly improved the fetal outcome in terms of preventing pregnancy induced hypertension (PIH) and recurrent pregnancy loss.
The average weight of an Indian New-born is 2.5 kg-almost a kilogram less than babies of other origins. But doctors said that pregnant women taking this capsule had given birth to babies weighing almost 4 Kg. “ The drug enhances the development of the baby, and keeps him/her away from physical ailments,” said Dr. YM Nandewar, head of gynecology, Sion Hospitals.
When contacted via e-mail, Dr Robert Saper, director, integrative Medicine Department, Boston University medical School, wrote back, “we believe that Ayurvedic formulations can play a tremendous role in achieving the goal of a baby born with good birth weight.” He also expressed hope that the new joint study would reconfirm the earlier findings about Ayurveda.
However, despite the efficacy of the drug, no scientific trial was conducted to check how long it protected a child from ailments. “Our study, to be conducted on 200-300 pregnant women, should answer all queries about the drug answer all queries about the drug,” said Palep.
Aparna chandivede, professional and mother of two
Andheri resident chandivede opted for Sujat during both her pregnancy terms. She claims that the drug had miraculous results. “Both my kids are active and organised unlike other kids.” She claims that her Son Rohit,7, is always the first one to finish tasks in his classroom and he helps out others after that, Also, they do not suffer from the occasional cold and fever and both had very clear vocabulary when they were only a year old. Also, her children weighed about 4 kilos during birth which is way above the average Indian weight.
They came with frozen embryos, returned with baby
Mumbai: Even the heavy downpour could not dampen Israeli couple Dotan Gilat and wife Irit Zan’s mood as they winged their way back to Jerusalem. The couple had come to Mumbai after reading about the quality reproductive care offered by this city’s doctors. And Mumbai had delivered—in their arms was their 20-day-ild son Dean and in their baggage was the paper-work tested -to his birth. On the one year ago, the couple had arrived in Mumbai anxioty cradling a special nitrogel tasket that contained seven of their embryos that had been frozen in an infertility clinic in Jerusalem. A local woman “who spoke no English” was to be the surrogate mother .”patients like Irit Zan who fail to get pregnant despite several attempts are considered for surrogacy as per the low, ”said infertility specialist Dr. Harishkesh Pai.
While most foreign reproductive tourists harvest an egg or donate a perm sample locally, 47-year-old Irit brought their frozen embryos with them(see box). The couple had to take permission from the Jerusalem IVF clinic to carry the embryos to India.
“For over a decade we tried to conceive but were never successful,” said Irit, gazing at her son’s crib. The Israeli couple are among a handful of foreigners n who have managed to bring their embryos from their home country.”We have had two other such cases, “said Dr. Pai who works at LiIavati Hospital. One couple packed the sample into the cargo, which resulted in the fragile consignment being damaged. The other NRI couple delivered two weeks ago but didn’t want to be interviewed, he said.
Test tube tourism a growing threat’
Infertile couples seek IVF countries Where It’s Cheaper
London: Thirty years after doctors delivered the world’s first test tube baby Louis Brown, fertility experts say they must tackle a growing problem of reproductive tourism that puts women and babies at risk
Cheap flights, open borders ----rapid-fire medical advances have in the past few years made it much easier for infertile couples to seek in vitro-fertilization treatments in countries where such procedures cost far less.
The issue, these experts say, is that without an international set of standards to help people choose a safe place to go, too many couples end up taking big risks a t clinics that may not have adequate standards. In some cases, desperate couples may not know where the eggs come from, or a woman returns pregnant with multiple embryos.
“Governments, patient organizations and doctors should organize awareness campaigns to warn citizens for possible dangers of cross-border care and to perform them of the possibilities”, ---penning , an ethicist at
Ghent University in Belgium, said percent conference.
More than million babies have been born worldwide using assisted reproductive technology since July , 25,1978, when University of Cambridge researchers Robert Edwards and Patrick Steptoe delivered Louis Brown by caesarean-the world’s first test-tube baby.
But that number is growing even faster these days because more and more women are waiting longer to start have children, and cheaper air travel makes it possible for even more couples to seek IVF.
The treatment involves surgically removing eggs from a woman’s ovaries and combining them with sperm in the lab. Doctors then pick the best embryos--- typically one or two---and implant them in the woman’s uterus.
Europe leads the way in the number of procedures, followed by the US, But other nations are catching up and European fertility experts see a rise in the number of women returning from treatment in other countries with multiple pregnancies. This means safety measures introduced in some countries are restricted or illegal in others. In Italy, for instance, friezing embryos is outlawed, forcing some people to turn to treatment in other countries.
An important difference occurs in the rules on the maximum number of embryos that can be transferred to a womb. In Britain and Scandinavia, only one or two are allowed, but other countries do not have the restriction, increasing the risk of twins or triplets.
Higher costs in western Europe drive many couples to eastern Europe and beyond where they can receive treatment for far less, experts say.”Patients often come back with a high,” said Franchise Shenfield of University College London, who focuses on ethics as a member of the European Society if Human Reproduction and Embryology.
Thirty years after British doctors delivered the world’s first test tube baby, Louise Brown, fertility experts of reproductive tourism, which puts women and babies at risk due to lack of quality treatment.
It’s a boy, made in the US
New Delhi: As the government cracks the whip on sex determination clinics in the country, India ‘s rich couples are heading for the US to realise their dream of a baby boy. With th e science of a technology that can select the sex of a child at the conceiving stage, Indians are shelling out over Rs 10 lakh to order a male baby. A US doctor confirmed among the Indians who visit him, an overwhelming majority asks for a baby boy.
A Los Angeles-based fertility doctor, Jeffrey Steinberg, who specializes in sex selection treatment, has been seeing a number of Indians travelling all the way to his clinic, Fertility Institutes. “We see about two-four couples from India every month, “he said , adding, “The request from Indians is primarily for boys.” Although he refused to divulge the details of his clients, the revelation doesn’t come as a surprise considering the desperation of Indians to have a boy.
Anoop Gupta , who runs Delhi IVF and Research Centre, recalls meeting an industrialist who with wife travelled to the Virginia-based Genetics & IVF center, the other popular destination or gender selection, to have a boy. Once they learnt of the gender selection technology, they headed for the US—but only to return empty handed and poorer by Rs 30 lakh.
With the treatment costing $19,000-plus the travel expenses, it’s mostly the well-heeled who can go for it. Steinberg, however, claimed that he receives several middle class couples “who have saved their resources or get family help for this treatment”.
The technology was primarily meant to identify embryos that may be carrying fatal genetic disease. But in the last few years, the technology has been used to choose the sex of babies. In fact, the first baby girl was created in 1995 by a technology called MicroSort. In the US and Canada, couples are opting for the technology for “family balancing”. Which means if a couple has three boys , they may ask for a girl or if they have two boys and one girl, they may want another girl to balance the family. Indians, too, have cited family balancing as the reason. But this could be a cover-up.
The technology involves creating embryos outside the womb. Once the embryos have grown, a cell is taken from each of them to determine the gender of each embryo. An in-vitro fertilization technique helps in determining the gender with almost 100% certainty. Once the information is available, within 24 hours, only then the embryos of the chosen sex are implanted.
MADE TO ORDER
A growing number of parents now have the ability to choose the gender of a child before conception. Though illegal in India. This methods available in US
Preimplantation Genetic Diagnosis
1Originally designed for detecting genetic disease. Using IVF techniques. Doctors remove eggs from the woman and fertilise them with sperm in the lab. Creating embryos.
2After three days, technicians extract a cell from each embryo. They can differentiate male and female embryos by examining their chromosomes. If they spot an XY. They know it’s a male
3After determining the sex of embryos, doctors implant the desired ones. While invasive and costly, success (after achieving pregnancy) is usually guaranteed.
TREATING INFERTILITY
Today there are various methods of treatment available for male infertility. Zeenia F Baria reports…
‘Even men with no sperms or very few sperms can become fathers with the treatments available today’
Male infertility is a problem that has been plaguing couples for a long time. Thanks to medical breakthroughs, today there are several methods to help couples conceive. According to consultant gynecologist Dr. Rishma Dhillon Pai, when a couple fails to conceive even a year after trying for a baby, it is labeled as infertility. “ The man is responsible for infertility in 30 to 40 percent of the cases. The semen analysis may show low sperm count or movement(normal is more than 20 million sperm / ml and more than 50 per cent motility) or in some cases , no sperms in the semen sample ,” she says.
Some of the common causes of male factor infertility are sexually transmitted diseases like gonorrhea or Chlamydia, which may cause blockage of the tubes that carry the sperms. “Mumps in childhood can cause testicular damage and failure and absent sperms. A boy may be born with congenital absence of the vas or the tests may not come down into the scrotum at birth and this can cause damage to tests and failure of sperm production. Swelling of blood vessels around tests, surgery for hernia, hydrocoele can all lead to make infertility. There are many new treatments for male factor infertility whereby even men with no sperms or very few sperms can become fathers. When the count is at least 10 million, an intrauterine insemination (IUI) can be tried. Here the semen is washed by special methods in the laboratory and a small quantity of sperms are placed with a thin tube right inside the uterus (womb) . This is a simple and inexpensive procedure, ”says Dr. Pai.
If the counts is very low then the procedure of choice is ntracytoplasmic Sperm injection (ICSI)which is like a test tube baby procedure. “ The woman’s eggs are removed with a needle under sonography control. The eggs are placed under a microscope and each sperm is picked up with a needle and injected directly into the egg with a micromanipulator. The eggs then fertilise and divide and after two to three days the embryo is put back into the womb of the wife . In cases where there are no sperms in the semen and if the man’s hormone test is normal, then the sperms can be removed directly from the tests with the help of a tiny needle. In some cases, there is complete testicular failure with abnormal hormones and no sperms are seen in the tests on biopsy. In these cases, the only treatment is to use donor sperms. These are taken from a semen bank where HIV, hepatitis B etc tested donor semen is banked. This is inseminated into the women and one can obtain a high rate of pregnancy by this simple and inexpensive technique of donor insemination,” she says.
According to gynecologist Dr. Nandita Paleshetkar, in our country, nearly 20 million couples suffer from infertility.”Those patients who don’t conceive even after three to four attempts of ICSI can opt for donor sperm. In fact today we can say that no man is infertile.’ whatever may be the cause of infertility , it is now possible to have a baby of your own gens with the help of Artificial Reproduction Techniques (ART). So consult your physician as soon as you feel there is some problem and do not to attach blame to yourself or your partner, even if one of you is facing infertility. Scientific advancement in the infertility field is moving at a very fast pace and hopefully soon there will be more answers to the problems faced by couples who desire to have their own children, ”says Dr. Palshetkar.
