There’s always hope

There’s always hope
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First Published: Fri, Jun 20 2008. 12 21 AM IST
Updated: Fri, Jun 20 2008. 12 21 AM IST
Time was when infertility was considered a social stigma and a couple without children had nobody to fall back on for support. Not any more, though.
Radical advances in reproductive technology, and a continuously changing mindset towards infertility therapy, have made the assisted reproduction route a much more attractive option.
Infertility specialist and medical director of the Delhi IVF and Fertility Research Centre, Anoop Gupta, says: “For anybody and everybody who has the urge to procreate, in 90% of the cases, their wishes can be fulfilled.”
Sudarshan Ghosh Dastidar, director of the Ghosh Dastidar Institute for Fertility Research, Kolkata, says that around 10-15% of couples in India are infertile and up to 20% of such cases are either unexplained or caused by a combination of male and female factors.
He has a word of caution for parent-hopefuls, though. “The chances of success fall dramatically if the mother is older than 40 because by then she would have already exhausted her good-egg pool,” he says. Keeping a healthy and rational perspective on the entire process is another important factor, says gynaecologist Urvashi Sehgal, co-founder of Phoenix Hospital, New Delhi.
Remember, the path to conceiving a child can be complex, costly and even confusing. To help demystify the process, we give you a step-by-step road map of the many stages of fertility treatment.
Stage I
The treatment begins with hormonal infusions—first via oral tablets, and later with injections—to stimulate the body to make more eggs.
Cost: For oral drugs, up to Rs500 per ovulation cycle. This includes commonly prescribed medications such as clomiphene and hormone HCG (Human chorionic gonadotropin).
Injections: These become more expensive as the dosage increases. A patient would initially receive 4-8 injections per cycle, with each injection costing between Rs500 and Rs1,000.
Success rate: 20-40% of the patients receiving infertility drugs and shots conceive within 3-6 months.
Stage 2
If pills and injections don’t work, and the doctor has ruled out problems such as blocked fallopian tubes and ovarian cysts, the next line of treatment is a relatively quick and painless procedure known as intra-uterine insemination (IUI). In this, doctors “wash” freshly collected sperm—distilling it down to only the strongest sperm—and inject it directly into a woman’s uterus around the time that she is likely to ovulate.
Cost: Around Rs15,000-25,000, including doctor’s fees, injection and medication costs.
Success rate: It varies, but doctors estimate that 40% of the patients are likely to conceive after 2-3 cycles of IUI.
Stage 3
If IUI doesn’t work, doctors try in vitro fertilization (IVF). Here, ovulation is hormonally induced through a series of daily injections. The eggs released are retrieved from the ovaries and allowed to be fertilized by sperm in a laboratory dish. After a few days, the fertilized eggs are transferred into the patient’s uterus.
Cost: IVF costs well above Rs1 lakh per cycle. This cost includes doctor’s fees, injections and medication costs.
Success rate: It varies with the patient’s age and most patients undergo at least 2-3 IVF cycles. For patients in the age group of 30-35, IVF success rates are around 35-40% per cycle. For women above 40, this falls to around 18%.
Doctors also caution that even if a cycle of IVF culminates in conception, 12-15% of such pregnancies end in miscarriage.
IVF-ICSI: Intra cytoplasmic sperm injection (ICSI) is an IVF-related technique that is used when the problem is with the male partner. In this highly delicate procedure, doctors retrieve a single healthy sperm cell from the male partner’s semen and inject it directly into the egg.
The fertilized egg is then injected into the uterus.
Cost: Around Rs10,000-15,000 more than IVF.
Success rate: It is roughly equal to IVF.
Stage 4
If IVF fails despite multiple attempts, , patients can resort to a few other options.
Egg donation: You can procure viable eggs from a donor, which would cost anywhere between Rs10,000 and Rs25,000.
Surrogacy: Surrogate mothers are women who agree to bear the child for an infertile couple. They may be genetically related or could be implanted with an unrelated embryo. Surrogate mothers earn anywhere between Rs1.5 lakh and Rs3 lakh.
Amita,29
Kolkata
This businesswoman from Kolkata has been undergoing assisted reproductive treatment for the last two years, and after trying several months of hormone injections and two failed cycles of IUI, Amita is going to begin her first cycle of IVF this month. She says: “The process definitely takes up a lot of time, and I have to plan work commitments around it. But you feel you are doing all this for such an important part of your life. I see 40-year-old celebrities like Farah Khan having triplets through IVF. I am not even 30 yet.” Amita and her husband have so far spent Rs1 lakh and expect to invest another couple of lakhs of rupees in the IVF process.
Josephine, 48
London
This London-based CARE worker for the elderly is in New Delhi, undergoing her first cycle of IVF. Josephine already has a 30-year-old son, but after suffering a life-threatening brain aneurysm last year, this Irish woman realized that what she wanted more than anything else was to have another child. As the father of her son had died many years earlier, Josephine purchased sperm from Fairfax Cryobank, a US-based sperm bank, and had it flown to her fertility clinic here in India. “I am doing this in India because the treatment is a third of the cost of fertility treatment in the UK. Still, I am draining all my savings for this. I know I am old, but the doctors say my eggs look healthy.” Josephine plans to invest in one cycle of IVF.
Ashish Mathur,33
Bandel (West Bengal)
This sales executive became the father of a son last month after nine long years of failed infertility treatment. Mathur suffers from low sperm count and his wife had a history of gynaecological complications.
The couple had a son after a successful cycle of IVF-ICSI. For other couples embarking on the IVF journey, Mathur has a word of caution, though:
“It is very important to build a good relationship with your doctor, have realistic expectations and constantly ask about the developments.” Over a period of nine years, the Mathurs have spent around Rs5 lakh.
NON-MEDICAL INTERVENTION
There has been a lot of research on how to boost fertility without medical intervention, in both men and women. A list of the dos and don’ts
FOR MEN
Wear boxer shorts. Briefs have been shown to reduce sperm count as they hug the body and increase the temperature, which is not conducive to sperm formation
Don’t keep your mobile in the trouser pocket. Mobile radiation has been shown to reduce sperm production
Exercise, but in moderation, and not in the heat. Again, raising body temperature interferes with sperm count.
Eat lots of tomatoes. Lycopene in tomatoes has been proved to increase sperm production. Doctors even prescribe a pill based on it as a routine measure for infertile couples
Take lots of vitamin C, vitamin E and selenium. These are known to increase sperm motility
FOR WOMEN
Exercise. It keeps you fit, making the body most receptive to conception
Lose weight. Obesity leads to hormonal imbalance, which affects fertility
Eat lots of fruit and vegetables. Antioxidants in them lead to healthier eggs
FOR BOTH
Avoid stress. Stress hormones block the action of certain hormones that are key for conception
Sleep well.This is a major factor in increasing conception rates
Avoid food and water that could be contaminated with pesticides.Pesticides interfere with fertility by mimicking reproductive hormones in your body
Quit alcohol. Excessive alcohol can lead to ovulation problems in women and defective sperms in men. Some studies even show it kills sperm-producing cells lining the testicles
Quit smoking. Direct relation shown between fertility and smoking, affecting both sperm and egg quality and quantity
Get checked for sexually transmitted diseases. These can prevent fertility
Get checked for diseases such as diabetes, hypertension, and non-pulmonary tuberculosis. These can affect fertility and need to be treated and controlled
( - Supriya Bezbaruah)
(The prices mentioned are for private clinics and may vary from city to city.)
Information on treatment options and costs courtesy Sudarshan Ghosh Dastidar, Anoop Gupta and Urvashi Sehgal
Write to us at businessoflife@livemint.com
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First Published: Fri, Jun 20 2008. 12 21 AM IST