National & In­ter­na­tional In­ter­ac­tion

IVF India - - Jalandhar, Punjab -

Q. Since how long are you do­ing IVF?

A. I am in­volved with IVF & In­fer­til­ity since 1989 where I joined Dr. Sadhna De­sai's team at Mum­bai who gave her 1st re­sult in 1984 only 6 years af­ter world's first test tube baby. I work ex­ten­sively in IVF at that clinic for 3 years. Since then I'm in­volved with IVF. Though I am fi­nally set­tled in Ja­land­har since 2000.

Q. How did you choose this par­tic­u­lar branch of medicine?

A. I chose this branch of medicine as the mis­ery of in­fer­tile cou­ples used to touch my heart. Al­ways be­ing in­volved with la­paroscopy since 1982, I had been wit­ness to lots of cases of blocked tubes & en­dometrio­sis where preg­nancy was not pos­si­ble. I al­ways dreamt of be­ing able to do some­thing for them. Then in 1989, I heard of Dr. De­sai's work in IVF , I left my well es­tab­lished prac­tice at Chandi­garh to join her. That was my initiation in IVF and later I went for train­ing in op­er­a­tive la­paroscopy & hys­tero - scopy to Royal Free Hos­pi­tal, Lon­don, Eng­land & Franken­klinik, Kiel, Ger­many in 1992 and 1993 resp.

Q. How far do you think you have suc­ceeded in your en­deav­our?

A. I feel fully sat­is­fied with the level I have achieved es­pe­cially when I look back & see that my train­ings and ex­po­sures to dif­fer­ent cen­tres & dif­fer­ent modal­i­ties of treat­ment have made me a com­plete gy­nae­col­o­gist with a good ex­pe­ri­ence in La­paroscopy, Hys­teroscopy, & ART. We have achieved preg­nan­cies with all types of treat­ments in our cen­tre: preg­nancy with sim­ple in­duc­tion of ovu­la­tion, preg­nancy af­ter hys­tero­scopic can­nu­la­tion of tubes, or la­paro­scopic fim­bri­ol­y­sis, sim­ple IVF, sim­ple ICSI, oocyte do­na­tion, sur­ro­ga­tion, preg­nancy with frozen em­bryos, preg­nancy with em­bryo do­na­tion and even with TESE and of course plenty of IUI preg­nan­cies.

Q. What mo­ti­vates you in this field?

A. To be very hon­est, when I see ig­no­rance, mis­ery & mal­treat­ment in this field it mo­ti­vates me to work harder and to find easy so­lu­tions for pa­tients' prob­lems.

Q. Is IVF dif­fi­cult to go through from a pa­tient's per­spec­tive?

A. From a pa­tient's prospec­tive IVF is dif­fi­cult to go through es­pe­cially when they have fi­nan­cial & re­source con­straint. But we are try­ing to sim­plify & make it much af­ford­able & sim­ple for them by re­duc­ing the dose of in­jec­tions, num­ber of vis­its to the cen­tre etc. etc. Still they need lot of coun­selling to go through all this in an easy way.

Q. What is your idea of good pa­tient care?

A. My idea of good pa­tient care is aware­ness, so that pa­tient should be prop­erly coun­selled and should have proper in­for­ma­tion re­gard­ing what is go­ing to hap­pen and what all Is in­volved.

Q. What is the kind of care a pa­tient can ex­pect at Shivam?

A. At Shivam, pa­tient can ex­pect a very warm, in­ter­ac­tive and lively at­ti­tude of all staff mem­bers. Ev­ery­body is very sym­pa­thetic and ready to help. We re­spect:

* Pa­tient's emo­tions

* Pa­tient’s pri­vacy

* Pa­tient’s Rights to the In­for­ma­tion

Q. What are your mem­o­ries of the first IVF Baby you helped con­ceive?

A. The first IVF baby was born to a lady who had never had her pe­ri­ods so it was an IVF with oocyte do­na­tion. Af­ter mak­ing a good lin­ing of the uterus & em­bryos out of the hus­band's sperms & donor oocytes were de­posited in the uterus. Ar­rival of the baby Alisha was a mat­ter of joy for all. Now the baby is 12 years old.

Q. Can you share a few mem­o­rable cases?

A. The mem­o­rable cases are:

1. A Kenyan lady from Nairobi af­ter get­ting a suc­cess­ful IVF preg­nancy at our cen­tre went back to Nairobi. She had a se­vere headache in the 4 month of preg­nancy. On CT scan it was found to be a brain hem­or­rhage due to rup­ture of aneurysm from a brain blood ves­sel.

Since this surgery was not avail­able in Kenya, she flew back & straight came to Ja­land­har. Luck­ily, my hus­band be­ing a neu­ro­sur­geon, han­dled the case.

Dilemma: (i) Preg­nancy is pre­cious (ii) Lady's life is still more pre­cious. So both had to be saved. She had de­vel­oped hy­dro­cephalus & se­vere headache

So­lu­tion : De­cided to op­er­ate in phases, while keep­ing the preg­nancy in­tact.

Phase 1, we op­er­ated hy­dro­cephalus by putting a shunt in the brain.

Phase 2, Aneurysm was clipped af­ter one week de­cid­ing not to touch preg­nancy.

By the grace of God baby with stood both the op­er­a­tions & anes­the­sias. She went back with a healthy baby.

2. A post­menopausal lady with azoosper­mic hus­band, took frozen em­bryo do­na­tion from an­other pa­tient who had suc­cess­ful preg­nancy & de­liv­ery. De­liv­ered a healthy fe­male child af­ter 9 months.

Q. What are the most im­por­tant changes in tech­nol­ogy in the last few years?

A. Tech­nol­ogy is chang­ing ex­po­nen­tially in the last few years. We are head­ing to­wards de­signer ba­bies now. Through PGD you can delete cer­tain dis­eases, choose dis­ease free em­bryos. We have many more fea­tures be­ing added due to tech­nol­ogy. Now even Azoosper­mic males can have a hope. IMSI is an­other tech­nique for oligosper­mic males to be able to choose good sperms.

Q. Do you be­lieve the suc­cess rate would im­prove in view of such changes?

A. Suc­cess rate is also im­prov­ing each day but more so, more and more peo­ple can think of hav­ing their own baby. But ev­ery treat­ment has pit falls. High hopes given by th­ese treat­ments can some­time lead to de­pres­sion in failed cases.

Q. What are the big­gest hur­dles of mak­ing ART avail­able for the masses?

A. Cost and aware­ness amongst both doc­tors & pa­tients is the big­gest hur­dle. We get pa­tients who have been try­ing with quacks, baabas & other G.P's for a very long time when the ovar­ian re­serve of fe­male is fin­ished or the male has a bad sperm count due to de­pres­sion. Then they are re­ferred.

Q. Do you think the govern­ment should help in­fer­tile cou­ples?

A. Govern­ment should help in­fer­tile cou­ples as they in­sti­tute pro­grammes for pop­u­la­tion con­trol. Hav­ing ba­bies is also im­por­tant for the men­tal & phys­i­cal well be­ing of a fam­ily. They should have very ac­tive agen­cies for the place­ment of par­ent­less chil­dren in the care of child­less par­ents.

Q. What spe­cial fa­cil­i­ties do you of­fer pa­tients seek­ing ART pro­ce­dures at Shivam?

A. Shivam is a unique cen­tre north of Delhi where the ART in­charge is her­self look­ing af­ter the en­tire process of treat­ment. She is fully qual­i­fied & for­mally trained. This is the only cen­tre North of Delhi which is ap­proved for train­ing of qual­i­fied gy­nae­col­o­gists in the field of In­fer­til­ity & IVF (It is a FOGSI cer­ti­fied course). We have full time em­bry­ol­o­gist who has a vast ex­pe­ri­ence & is a de­gree holder from Leeds Univer­sity. Treat­ments are done ac­cord­ing to the need of pa­tients. Not all those who came for IVF, are of­fered IVF.

Q. Af­ter help­ing so many distressed cou­ples, how do you un­wind to take on an­other chal­leng­ing day?

A. You are absolutely right that af­ter a days' work you feel sat­is­fied and tired. I use mu­sic, med­i­ta­tion and so­cial­iz­ing to un­wind from the com­plex­i­ties of a day's work.

With Cathey(renowned em­bry­ol­o­gist) from Bel­gium

With Prof- Paul Devroey Chair­man ESHRE

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