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Break Silence Around Infertility: Experts answer all about fertility treatments, IVF & alternatives

Infertility can be an intensely personal subject not many want to talk about. But what exactly is IVF and who should go for it? India TV got in touch with fertility experts to know more about the subject.

Tripti Narain Tripti Narain @TriptiAbhishek
New Delhi Updated on: July 29, 2021 20:08 IST
Break Silence Around Infertility: Experts answer all about fertility treatments, IVF & alternatives
Image Source : PR FETCH

Break Silence Around Infertility: Experts answer all about fertility treatments, IVF & alternatives

According to the report published in 2019, the India IVF services market is expected to reach $1.45 billion by 2026, portraying a compound annual growth rate of 14.7% from 2019 to 2026. With changing lifestyle and external factors like pollution, stress, etc., the rate of infertility is predicted to rise with time. However, the doctors have raised concerns regarding the silence around infertility. The number of infertile and sub-fertile individuals is not properly reported because it is still not considered as a medical condition. The advancements in the IVF industry have enabled various treatments for infertility, available for almost everyone. 

India TV got in touch with fertility experts to know more about the subject. Here are the excerpts: 

Infertility can be an intensely personal subject; how do you think you can make people more aware of this common issue?
Vinesh GadhiaIndia CEO, ART Fertility Clinics: In India, infertility is considered as an incapability and a reason to disregard people. Our aim is to spread awareness and make people recognize infertility as a medical problem. We want people to treat this as any other disease and encourage them to consult specialists. In our recent campaign #UnComplicate, ART Fertility Clinics associated with the world’s first IVF baby, Louise Brown to break the different misconceptions and hesitancy around IVF. 
Considering the sensitivity around the topic of infertility, one of our five pillars that everyone at ART Fertility Clinics is trained for is empathy and compassion towards patients. When the patients build a sense of trust on the medical assistance provided, they feel more comfortable sharing their problems and thus it becomes easier to design the right kind of treatment for them.
Infertility seems to be a generic term for all problems related to a couple not being able to conceive. What exactly is IVF and who should go for it?
Dr Gurpreet Singh Kalra, Medical Director Designate ART Fertility Clinics: In-Vitro Fertilization (IVF) refers to the process of fertilization that occurs outside the human body. This process takes place in the embryology laboratory where the woman’s oocytes (eggs) and man’s sperm are fertilized together in culture media for embryo development. Embryo is subsequently placed back in the womb for pregnancy to take hold. The IVF technology increases the chances of conception for couples with fertility problems.
Generally, a young couple under 30 years of age who have tried to conceive naturally for a year and not succeeded, should consult a fertility specialist for further investigations. Women who are over 35 years of age should contact the fertility specialist after having tried unsuccessfully for 6 months. Women who know that their egg numbers are very low (low ovarian reserve), women whose fallopian tubes are blocked, or men with poor sperm quality, are very likely to need IVF and should therefore should not wait at all. For most patients, including those with polycystic ovarian syndrome, tubal obstructions, abnormalities of the womb, endometriosis and low egg numbers, IVF is the most effective infertility treatment. Men with poor quality sperm and low sperm count will need an additional advanced technique called Intra Cytoplasmic Sperm Injection (ICSI) where sperm is helped to fertilize the egg. After one is recommended a fertility treatment procedure, the female’s age and nature of infertility determine when they should opt for IVF. 
Success rate in IVF tends to decline with increasing age of women. It is therefore advised to seek opinion early to have your best chance of success.
Fertility treatments are prohibitively expensive and discourage many to pursue. What can be an alternative that is more pocket friendly or is there a scheme for such women?
Vinesh Gadhia: The cost of IVF treatment in India is usually between US$2,000 and US$3,000, while in developed countries such as the United States and Europe, the cost of a basic IVF cycle is about US$10,000 to US$15,000. Since most fertility specialists, consultants and caregivers in India can communicate in English, it is easier for patients and their families to understand treatment better and feel safer. 
Affordability of IVF in India is perceived to be costly, although it is one of the most economical IVF in the world. Anyone from a socio-economic background of middle class or above earning around Rs. 10000 a month have the capacity to go through one IVF cycle in a lifetime which gives them a significant chance to conceive. India is in a good position for medical tourism from across the world because it provides the most holistic approach in IVF at the most affordable cost.
Should there be a break between IVF cycles?
Dr Gurpreet Kalra: Although the biological conditions differ in individuals, a typical treatment cycle of IVF can last about four weeks. Following retrieval of eggs, a patient needs to wait for the fertilization of the egg with the sperm and transfer of the embryo, followed by a pregnancy test to know whether they need another IVF cycle. Typically, a new cycle can start about four to six weeks after the conclusion of a previous cycle Occasionally a treatment cycle can end in miscarriage or a rare ectopic pregnancy. In that case, it can take longer to recover.  It is advisable for the patient to wait long enough to heal physically and emotionally from the outcome of the previous failed IVF cycle before embarking on another cycle.
Can someone choose to go for twins or triplets? Is it controlled?
Dr. Gurpreet Kalra: In the not-so-distant past it was common to replace multiple embryos in the womb in order to increase chance of pregnancy. It is now rarer, but some clinics unfortunately continue to put back multiple embryos uncritically. Twins and triplets are an unwanted outcome of replacing multiple embryos. It is unwanted outcome because multiple pregnancies have a higher risk of complications with risks for the baby as well as the mother. This includes increased risks of miscarriages, high blood pressure, premature births, complicated delivery etc. As the treatments have become better with higher chance of success, the norm should be putting back one good quality embryo. Amongst others genetic testing has made it possible to identify embryos with a high chance of success. A pregnancy with one baby is the healthiest one for the mother and the baby. A choice of achieving multiple pregnancy is therefore not an option.
Considering that female fertility declines with advancing age, what are the options for women if they plan to delay having children.
Vinesh Gadhia: Women are born with approximately 2 million eggs in their ovaries. As they grow older, the concentration of eggs starts depleting. This has nothing to do with any form of birth control, pregnancy, hormone production, health, lifestyle, or nutritional supplements. 
IVF is a known scientifically proven technique with solutions specific to the needs, such as – oocyte (egg) cryopreservation for future fertilization. Another is ovarian tissue cryopreservation, where a woman undergoing cancer treatment preserves the ovarian cortex and when she is cured of cancer, the tissue can be thawed and re-implanted and ovarian function is restored.

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