THE IVF COMMANDO
Mumbai Fertility Clinic & IVF Centre
When did you start Bombay Fertility Clinic & IVF Centre? The clinic was established in 1994 with the sole aim of providing appropriate couple specific ART services after proper evaluation and counseling.
How did you choose this particular branch of medicine? Since I was in the 8th standard, I was passionate about reproductive medicine. Also, once I enrolled for my obstetric and gynecological post-graduation I was very sure that I would not be able to do abortions. Fortunately, I was exposed to the field of IVF at a very early stage of my career when I had the pleasure of working with the pioneers of IVF in India, namely Drs T C Anand Kumar and Dr Indira Hindjua at the KEM hospital and Institute for Research in Reproduction at Mumbai. Under the guidance of these doyens I was able to learn and master the skills of practicing successful IVF.
How far do you think you have succeeded in your endeavour? The clinic and myself have been blessed to this end performing close to 2000 IVF & ICSI cycles annually. The last one year alone resulted in close to 900 pregnancies with more than a 1000 take home babies from various procedures such as IVF, ICSI, IUI, Oocyte donation, Embryo donation and surrogacy. For the past three years we have been consistently maintaining take home baby rates in the range of 40-50% per started cycle.
What was the status of ART centres in India when you started as compared to now? Of course, there were a very few centres then (less than 50) when we embarked on this fascinating journey. Today we have close to 800 centres practicing infertility treatments and as per population studies and statistics, still not enough for this huge country.
What motivates you in this field? The happiness and smiles that just the announcement of the positive pregnancy test brings to the couple and their family are enough to keep me going for several more life times. To my mind, this field is more satisfying than any other field in medicine. It would be apt to mention that creating life (IVF specialists) and saving lives (cardiac surgeons) are amongst the two most satisfying careers that a doctor could select. Every positive pregnancy test still brings the same joy to the entire team as our first IVF pregnancy 18 years ago !
Is IVF difficult to go through from a patient’s perspective? Today, IVF is highly simplified compared to a few years ago. It entails just about 5 -6 visits over an entire month, fewer injections owing to more simplified and safer protocols, higher success rates because of state of the art equipments, disposables and culture media. Also, our centre provides all facilities for the procedure under a single roof thereby simplifying matters greatly for the already stressed couple. The clinic has also incorporated reflexology and other adjuvant therapies to help the couple to improve their response and success rates. Furthermore, studies have established beyond doubt that the procedure is safe and effective with no long term concerns such as cancer or other systemic side effects which could affect the future life of the woman. Success rates in the range of 50% ensure that the couple achieves its goal within 2-3 attempts. Furthermore, the easy availability of third party reproduction such as egg, sperm and embryo donation as well as surrogacy has revolutionized the field to ensure that no couple is deprived of a child.
What is your idea of good patient care? The first meeting is the most important when it is essential to screen all previous records, ask for valid additional tests such as the AMH for ovarian reserve, do an ul- trasound scan and then discuss all possible options with the couple. Sensitivity and compassion are of utmost important in advising options and discussing all pros and cons with the couple. It is important to hear them out and not be in a hurry to just dispose them of as just one more case. Thereafter, cycle management should be individualized and tailored to suit the patient’s needs to ensure that they go through the procedure as smoothly and without complications as possible. Protocols should be selected and designed to avoid complications such as ovarian hyperstimulation and multiple pregnancy. Communication with the main doctor or secretary or IVF nurse throughout the procedure is of vital importance to establishing a firm rapport with the couple. Also, post-failure counseling and support to the couple goes a long way in helping them have a good experience of the treatment.
What is the kind of care a patient can expect at Bombay Fertility Clinic & IVF Centre ? As highlighted earlier, a very patient hearing and evaluation at the first visit, constant encouragement and counseling by the secretariat, nurses and assistant doctors, minimal injections by way of individualized protocol selection, personal attendance by the main doctor at all steps of treatment and a sensitive and humane approach in case of failure are the landmarks of our center. Also, minimal visits and waiting hours and easy accessibility and communication with the main doctor and ancillary staff are very important at our clinic
What are your memories of the first IVF Baby you helped conceive? She was a lovely child born to Mrs P Mani of Bangalore and happened to be our 14th IVF patient in those days. I still have a copy of the letter she wrote to me and the entire team expressing how until that day her 14 years of married life had consisted of visits only to doctors
and temples all over the country. The emotional and sentimental side of not having a child were deeply expressed in that letter and till this date is a motivating factor for us whenever we are confronted with a new infertility patient.
You have seen the birth of thousands of IVF babies so far. Can you share a few memorable cases? We had a patient who presented at the age of 51 with a history of a tragic loss of her only daughter in a vehicular accident. Thinking that we would refuse treatment in view of her age she told us that she was 41. We tried IVF repeatedly for her but with no result. Finally after the 5th cycle I advised her to go for adoption but she insisted that she had full faith in the center and that we should try one more time. Lo and behold, she conceived in the 6th cycle and is now the proud mother of a 15 year old daughter. We have dealt with innumerable patients who have lost their children to accidents and natural disasters and by IVF we have managed to give most of them a new hope to live for. We also remember patients of premature menopause becoming mothers with the advent of oocyte donation and numerous patients of zero sperm counts who could have their own biological children thanks to testicular biopsy and ICSI. Of particular good memory was the case of a gynecologist (herself ) who was born without a uterus. We could do a laparoscopic egg retrieval for her and after IVF transferred the embryos to a surrogate mother who subsequently delivered a lovely daughter for her.
Medical research has taken great strides in the last three decades and there has been a tremendous and remarkable change in the technology that is used. Should patients be reassured by these developments? The field of Assisted Reproductive Technologies has witnessed a revolution over the past three decades.
Dr Jatin P Shah has the unique distinction of being able to perform all IVF tasks including ultrasonography, oocyte retrieval surgery, IVF embryology and embryo transfer single handedly. His ability to trouble shoot for problems in IVF & ICSI programs in different laboratories has earned him the nickname of "IVF Commando".
Today, practically every childless couple and also couples with recurrent miscarriages can hope for success with the wide range of treatment options available to them. We have witnessed the beginning of IVF conquering all forms of female factor infertility and ICSI doing the same for almost all forms of male factor infertility. Furthermore with the advent of IMSI, we are able to select the morphologically most healthy sperm for ICSI and with the Embryoscope would be able to select the most viable embryo for transfer (thereby reducing multiple pregnancy rates). Furthermore, refinements in egg and embryo freezing techniques gives hope to many a cancer patient who can preserve his or her fertility with these techniques before embarking on chemo or radiotherapy (which is likely to destroy fertility forever).
What are the most important changes in technology in the last few years? The availability of drugs with consistent quality manufactured by the recombinant technology (for ovarian stimulation), ready to use culture media with perfect ingredients for embryo culture and optimized lab ware such as incubators, egg retrieval needles and embryo transfer catheters have made sure that every successful unit has an optimal ongoing pregnancy and live birth rate.
Do you believe the success rate would improve in view of such changes? Individualized drug protocols, selection of the most appropriate ART method, perfect cycle co-ordination and monitoring, emphasis on safety and quality control would surely enhance success rates.
What are the biggest hurdles of making ART available for the masses?
“We have dealt with innumerable patients who natural disasters and by IVF we have managed particular good memory was the case of a gyne could do a laparoscopic egg retrieval for her & surrogate mother who subsequently delivered
have lost their children to accidents and to give most of them a new hope to live for. Of cologist who was born without a uterus. We after IVF transferred the embryos to a a lovely daughter for her.”
Lack of insurance cover and cost of treatment is still the biggest hurdle in making these techniques available to one and all. Fortunately, the costs in India are still the lowest compared to practically every other country in the world which makes it attractive for most of the middle class and a lot of international patients too.
Do you think the government should help infertile couples? Government could surely play an important role by implementing the Guidelines for ART as Law at the earliest to prevent misuse of these techniques. Also, subsidies on imports of consumables and culture media as well as drugs could surely help to reduce the cost of treatment. Moreover, facilities for IVF should also be incorporated in government and municipal institutes to reduce the costs even further and let every Indian have access to these wonderful techniques.
What special facilities do you offer patients seeking ART procedures at Bombay Fertility Clinic & IVF Centre? Individualized care, super secretariat and counseling facilities, all facilities under one roof, constant upgradation of equipment and technology, staff updates and training in the best facilities in the world on a constant basis, adjuvant treatments such as reflexology, patient support groups and post failure counseling and support are some of our specialities.
After helping so many distressed couples, how do you unwind to take on another challenging day? An hour of intense exercise at the gym followed by some good music, the occasional movie and meeting friends both from within and outside the fraternity helps me chill out before embarking on a new day of treating distressed patients.
Dr. Jatin Shah MD.DGO Mrs Nina Shah ADMINISTRATOR
Dr. Ja n Shah with wife Nina & son Dharam