Giving Hope to Hope
MEET DR. SONIA MALIK
When did you start Southend IVF? Southend IVF was started in the year 2001.
How did you choose this particular branch of medicine? As a student of medicine in the early '70's, I noticed that there was very little to offer these unfortunate couples in the form of treatment. So, I started working with whatever little we had and gradually kept learning as I treated more and more couples who went through the pain of childlessness. Eventually I was able to start a centre where I could offer all the latest technology and medicine to them.
How far do you think you have succeeded in your endeavour? I have over the years had the opportunity to treat many infertile couples and bring happiness to them. I have managed to do what I had planned through ethical evidence based practice.
What was the status of ART centre’s in India when you started as compared to now? ART was available to only a very few when I initially started this centre. However, centres have now mushroomed all over the country. Many are unable to maintain the standards of space, equipment and manpower requirement. On the other side of the spectrum there are also state of the art IVF centres which have come up and have lent a commercial angle to this field due to heavy investments made in infrastructure. Recently, importance of guidelines for ART centres is being stressed on. Once the regulations come into force, the situation may become more uniform.
What motivates you in this field? The fact that I have been given the opportunity to provide childless couples with the boon of parenthood is a big motivation.
Is IVF difficult to go through from a patient’s perspective? Yes, it is a difficult procedure, not in terms of inconvenience of the pro- cedure but in terms of the stress, costs and failure rates the patient may have to encounter. As a procedure, it is fairly simple. The ovaries are stimulated to produce excess amounts of eggs which are retrieved by ultrasound guided aspiration, a short procedure done under general anesthesia. Once the oocytes are aspirated they are fertilized in a petri-dish with sperms and developed to 8 cell stage. After this the embryo is deposited in the uterus through a catheter. This procedure is a simple one which does not require anaesthesia.
What is good patient care? Good patient care involves treating the patient both in body and mind. It must follow evidence based guidelines. To this, ones own experience must be included to take the right decisions. To counsel patients about various treatment options their success and failure rates is a must.
What is the kind of care a patient can expect at Southend IVF? We at Southend believe that an IVF procedure involves not only reaching the target of making a baby but along the route taking care of the stress which the patient undergoes both because of the procedure and the infertility she has. It is important to counsel these patients many of whom suffer from poor self esteem. Also as the success of IVF has limitations, counseling patients in case of a failure is important. We also believe in providing treatment which is evidence based and scientifically accepted. We also from time to time bring in the recent developments in protocols and equipment in the field of assisted reproductive technologies which is a fast changing field. In our laboratory we believe in quality control with all our procedures. We maintain a quality manual and all methods used are by standard operating procedures of international standards. We believe in transparency and our results are clearly displayed and explained to all our patients.
Medical Research has taken great strides in the last three decades and there has been a remarkable change in the technology that is used. Should patients be reassured by these developments? Yes. As the technology has improved the success rates have gone up. Earlier where we faced blocks, technology has cleared the path.
What are the most important changes in technology in the last few years? Technology has changed in the form of drugs, protocols, procedures and equipment. In many cases we are moving to milder and low cost stimulation protocols. Recent advances in equipment have brought in the embryoscope which is an incubator which visualizes the development of the embryo as it is dividing and captures their images as they are developing. This allows checking embryos without disturbing the culture environments. Besides this new technique known as IMSI allows us to see sperms at a very high magnification and enables us to choose the sperm which is morphologically normal. A morphologically normal sperm is usually genetically competent also and gives better pregnancy rates. Preimplantation genetic diagnosis is a recent development where a single blastomere is aspirated and sent for genetic analysis to ensure that the embryo transferred is genetically normal. This is indicated in case the parents have a genetic disease or in recurrent abortions and implantation failures. As far as embryo transfers are concerned we are now moving to only 1-2 embryos being transferred. In freezing techniques for preservation of embryos, a rapid freezing technique has come in called vitrification which allows better cryosurvival and pregnancy rates.
Do you believe the success rate would improve in view of such changes? Yes. As stated embryoscope, IMSI and vitrification improve pregnancy rates. Besides that mild stim-
ulation protocols and single embryo transfer prevent hyperstimulation and multiple pregnancies.
What is the biggest hurdle of making ART available for the masses? The cost of the technology makes it inaccessible for the masses. The drugs are also very expensive. Also there is limited trained manpower in this field. The need is evolution of a low cost program.
Do you think the government should help infertile couples? Definitely. Infertility is a disease and must be treated like all other diseases. The government must take responsibility in providing services to all infertile couples who undergo great amount of stress due to difficulty in accessing treatment.
What special facilities do you offer patients seeking ART procedures at Southend IVF? We may not be offering them anything different from other centres in terms of technology but we are certainly different in our approach to patients. We understand that an infertility centre cannot promise 100% results in ART, but our approach is to provide infertility solutions to each and every couple who visits us. A cheerful team and confidence in our guiding principles makes us a very positive centre for infertility treatment! There are no signs of negativity in our environment! Our patients who again come back to us after failed cycles are a reflection of confidence and satisfaction in our mode of treatment. We try to help patients choose the right treatment for them and help them with other options if they fail.
What is your vision for Southend IVF? A group known for its clinical excellence, ethical practice and compassionate approach to patients.
After helping so many distressed couples, how do you unwind to take on another challenging day? Every professional must learn to switch off once he/she leaves work or else the performance for the next day is affected. My little dog Google helps me do so! A welcome wag, a jump on me and his special bark for me are enough to make me forget work and relax.
Dr Jyoti Kumari MBBS, MS Dr Meenakshi Dua MBBS, MS Dr Sonia Malik DGO, MD, FICOG, FIAMS Dr Vandana Bhatia MD(Gynae)