National & International Interaction
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