Resched­uled…

With more than 15 years if ex­pe­ri­ence in the field of In­fer­til­ity and As­sisted Re­pro­duc­tion, Dr Nee­l­ima Gupta, is a Sr. Spe­cial­ist in ad­vanced ART tech­niques like IVF- ICSI, PGS, PGD and Male In­fer­til­ity. She is trained in UK and Aus­tralia for all as­pect

Woman's Era - - Short Story -

n 1978, a med­i­cal miracle hap­pened, when Dr Robert Ed­wards and Dr Pa­trick Step­toe ex­tracted a woman’s eggs from her body and fer­tilised them in a test tube and thus Louise Brown (world’s first test­tube baby) was born. Since then many ad­vances and newer tech­niques in ART ( IVF) have evolved; one of them is Egg Freez­ing (Oo­cyte Vit­ri­fi­ca­tion), wherein a woman’s eggs are frozen till she de­sires to have her baby.

Over the past few decades, so­cial and med­i­cal cir­cum­stances of women have changed dra­mat­i­cally. Now, she is not only a home­maker, but an in­de­pen­dent­ca­reer woman too, who can de­cide the mile­stones of her life. Since the age of mar­riage and pro­cre­ation is get­ting pushed further and further, women have al­ways felt the need to pre­serve their fer­til­ity.

As ev­ery woman is born with a fixed num­ber of eggs and they re­duce with age and ev­ery men­strual cy­cle, this race be­tween age and at­tain­ing mother­hood has al­ways been a prob­lem, es­pe­cially for ca­reer woman. It is not only about the num­ber of eggs but the qual­ity of eggs also, which de­te­ri­o­rates with age too, as the eggs of best qual­ity are utilised dur­ing younger years of life. As a woman crosses 35 years of age, chances of hav­ing a ge­net­i­cally ab­nor­mal baby are higher, mainly be­cause of the de­te­ri­o­rat­ing egg qual­ity. There­fore, this lat­est tech­nique is a miracle for them, to be able to freeze their eggs of good qual­ity, and use them when they want.

In ad­di­tion to this, it is also help­ful for women who, for their ma­lig­nant (can­cer) and pre­ma­lig­nant ( pre- can­cer) con­di­tions, are un­der­go­ing chemo­ther­apy or ra­dio­ther­apy. Chemo­ther­apy or ra­dio­ther­apy is such an in­ten­sive treat­ment that it is known to de­stroy eggs as well as caus­ing per­ma­nent dam­age to their qual­ity, which can lead to an ab­nor­mal or mal­formed baby later. So, freez­ing their eggs be­fore they un­dergo chemo­ther­apy or ra­dio­ther­apy cy­cles would be a bless­ing for them be­cause they would be able to pre­serve their fer­til­ity and have chil­dren later af­ter they com­plete the treat­ment. But in this sit­u­a­tion it is very im­por­tant that they ap­proach the right IVF clinic, where ex­perts are able to guide them, since they re­quire dif­fer­ent kinds med­i­ca­tion com­pared to rou­tine IVF ow­ing to their med­i­cal con­di­tion.

In ad­di­tion to the above con­di­tions, the tech­nique could be used for women with cer­tain spe­cific ge­netic prob­lems like Turn­ers Syn­drome and Frag­ile X Chro­mo­some where there are chances of pre­ma­ture ovar­ian fail­ure (mean­ing loss of ovar­ian func­tion be­fore usual time). Women with these prob­lems can freeze their eggs on time be­fore the ovar­ian fail­ure sets in.

The two known tech­niques for egg freez­ing are “Slow Freez­ing” and “Vit­ri­fi­ca­tion”. Of these, slow freez­ing is an older tech­nique com­pared to vit­ri­fi­ca­tion. Vit­ri­fi­ca­tion is the lat­est one with best re­sults, but only when it is done by ex­perts.

It is very im­por­tant for women opt­ing for egg freez­ing that they con­sult an IVF ex­pert, wherein they are prop­erly guided through the en­tire pro­ce­dure. Usu­ally, a typ­i­cal cy­cle of egg freez­ing re­quires ini­tial eval­u­a­tion with de­tailed his­tory, ex­am­i­na­tion and in­ves­ti­ga­tions. A set of blood tests for fer­til­ity hor­mones as well as ul­tra­sound is then ad­vised, which are typ­i­cally per­formed on sec­ond or third day of pe­ri­ods, in order to as­sess their ovar­ian re­serve (num­ber and quan­tity of eggs in ovary). Once the re­sults are ob­tained, they are coun­selled in de­tail about the whole process and out­come in their case.

It is again very im­por­tant to un­der­stand that treat­ment is very much in­di­vid­u­alised. De­tailed coun­selling is es­pe­cially needed for women who are do­ing egg freez­ing for the ge­netic, ma­lig­nant and pre­ma­lig­nant con­di­tions as men­tioned above.

Treat­ment cy­cle usu­ally con­sists of 10 -12 days of daily in­jec­tions (Stim­u­la­tion) to form mul­ti­ple eggs fol­lowed by the pro­ce­dure of Egg Har­vest­ing as the fi­nal step af­ter which eggs are im­me­di­ately frozen in the IVF lab for fu­ture use.

One of the main risks in­volved with the pro­ce­dure is over­pro­duc­tion of eggs with medicines (Ovar­ian Hyper­stim­u­la­tion). Need­less to say, this risk also can be avoided or at least min­i­mized if done un­der ex­pert guid­ance.

Sev­eral fac­tors have been at­trib­uted to the suc­cess of freez­ing of eggs such as age at which they are frozen, med­i­ca­tions used to stim­u­late egg pro­duc­tion, num­ber of eggs ex­tracted and frozen, method of freez­ing and de­vices used. Age re­mains the most im­por­tant de­ter­min­ing fac­tor of all the fac­tors men­tioned above (the lesser, the bet­ter and prefer­ably less than 38 years at the time of egg freez­ing).

One should also un­der­stand that in spite of the best pos­si­ble sce­nario, over­all suc­cess rate of egg freez­ing ( which means num­ber of eggs sur­viv­ing af­ter thaw­ing them) is 60-70%.

In the re­cent chang­ing times there is one more sit­u­a­tion where egg freez­ing is emerg­ing as a very good and vi­able op­tion. Nowa­days, need for egg do­na­tion is in­creas­ing in view of late age of child­bear­ing. The women who are in need of eggs in order to achieve mother­hood, also have an op­tion to ob­tain do­nated eggs by an egg donor like we have avail­abil­ity of sperms from sperm banks there.

How­ever, ev­ery new tech­nique comes with its own pit­falls. In case of egg freez­ing there is a lot of so­cial and me­dia hype as­so­ci­ated with it, as many celebri­ties have opted for egg freez­ing to pre­serve their fer­til­ity/ post­pone mother­hood and var­i­ous multi­na­tional com­pa­nies are pro­vid­ing fi­nan­cial as­sis­tance to their women em­ploy­ees who want to opt for egg freez­ing.

There­fore, it is ad­vis­able to un­dergo this pro­ce­dure only when one is in ac­tual need for it and should not just do it un­der so­cial pres­sure.

So women, let’s “Have it All” but only af­ter you “Know and Want it All”!

por­tions and pre­par­ing pack­ages to be de­liv­ered.

The evening of the Eid was for a fam­ily out­ing. All fam­ily mem­bers were packed in cars which made a bee line to Haji Ali Dar­gah. Cars were parked on the road and the fam­ily walked the long paved path through the sea to the dar­gah. The path was lined with hawk­ers and beg­gars on both sides. Some hawk­ing stalls sold trin­kets, some flow­ers and some sold eat­a­bles whereas some oth­ers sold sher­bets. Each beg­gar had a cry of his own.

eshma en­joyed watch­ing peo­ple, walk­ing up the path to the holy shrine. She was amused to find a beg­gar sell­ing loose coins. The group reached the shrine. They had to seg­re­gate. The women could not en­ter the sanc­tum of the shrine and so the flower chad­dar had to be taken by the male folks into the holy shrine to be placed on the tomb. There­after, the fam­ily moved around the court­yard of the shrine en­joy­ing the sea breeze. Cold drinks and ice-cream was or­dered for all and it was a big treat.

Reshma was 17 when she was mar­ried off to a cousin of hers. The mar­riage was a low-key af­fair. Bil­lal the cousin to whom Reshma was mar­ried was known to her. He was about eight years older than her. His fam­ily too was a con­ser­va­tive one and hence highly ap­proved by her par­ents. Bil­lal along with his fa­ther ran a pros­per­ous restau­rant busi­ness. He car­ried a beard which was fist­ful long, and he al­ways wore a skull cap. Bil­lal did not miss any of the daily prayers.

Reshma be­gan her new life in the mar­i­tal home. She be­gan to at­tend to cook­ing and other house­hold chores and was ap­pre­ci­ated by her moth­erin-law and fa­ther-in-law. Bil­lal had two sis­ters younger than him. The sis­ters Aisha and Bushra, were still to be mar­ried. These two sis­ters did not like Reshma es­pe­cially the way she had won the hearts of their par­ents. Grad­u­ally, Aisha and Bushra be­gan a whis­per­ing cam­paign against Reshma.

"You know, Reshma," said Aisha one day, "you are very good at cook­ing and other house­hold chores, and we like you for it. Your par­ents have groomed you well. But it would have been bet­ter if your par­ents had given at least ` 5 lakh as da­hej (dowry) for our brother Bil­lal. Let me tell you that be­fore the match with you was fixed, there was a pro­posal from an­other girl from our com­mu­nity and her par­ents were pre­pared to give ` 10 lakh as da­hej for our brother."

eshma heard this qui­etly and did not say any­thing in re­ply. But this kind of con­ver­sa­tion was re­peated time and again by her two sis­ters-in-law. This was a men­tal tor­ture to Reshma. She did tell Bil­lal about this con­ver­sa­tion. Bil­lal ad­vised her not to pay any heed to such talk though, he said, there was no truth in what they were say­ing.

Three months af­ter the mar­riage, Reshma found her­self preg­nant. The fam­ily was happy about it. The par­ents of Bil­lal were glad that they would soon get an heir to the busi­ness. Bil­lal him­self felt proud to be­come a fa­ther soon, but showed no such ex­pres­sion on his face. Aisha and Bushra be­came more ag­gres­sive towards Reshma. No re­lief was granted to Reshma in her house­hold chores. But Reshma made no com­plaint. The aura of mother­hood filled her with joy. When Reshma was seven months preg­nant, she was sent to her par­ents for de­liv­ery of the child. It be­ing the first child, the com­mu­nity cus­toms re­quired that her par­ents at­tend to the de­liv­ery of the child.

Once at the home, of her par­ents, Reshma took her own time to rest. Her mother of­fered her the nu­tri­tious food that a preg­nant woman is sup­posed to con­sume. Reshma went for reg­u­lar pre­na­tal med­i­cal check-ups and took the medicines as pre­scribed. Bil­lal was too busy in his busi­ness and never had the time to visit her or phone her, and so were his par­ents.

At the end of nine months, Reshma de­liv­ered a baby boy. Sweets were dis­trib­uted. Bil­lal and his par­ents vis­ited Reshma in the ma­ter­nity home. In the hospi­tal it­self the nam­ing cer­e­mony of the child was per­formed by a maulvi. The child was named Mujahid, a name cho­sen by Bil­lal and his par­ents. Reshma had se­lected the name Salim, but it had to be Mujahid. Four days af­ter the de­liv­ery, Reshma went to her parental home. Her mother took all care for the com­fort of Reshma and Mujahid.

n the sixth day Reshma found that while she was feed­ing Mujahid, he sud­denly turned blue and started gasp­ing for breath. She raised shouts and her mother came run­ning to her. She picked up the child on her left shoul­der and be­gan to mas­sage its back. Her mother be­gan to rub the bot­tom of the feet of the child. Af­ter some time, the child raised its head from the shoul­der of its mother. Reshma be­gan to cry. Her mother be­gan to pray and to call Al­lah and dasta­gir for help. Reshma's fa­ther phoned up Bil­lal and ap­prised him of the sit­u­a­tion. Mujahid was rushed to the hospi­tal.

Luck­ily the paede­tri­cian was in house. Reshma told the doc­tor what ex­actly had hap­pened. The doc­tor ex­am­ined the baby. An Xray was taken. The doc­tor opined that there was a hole be­tween the valves in the heart of the baby which was caus­ing the baby to turn blue and breath­less. The child was ad­mit­ted in the hospi­tal for treat­ment and the doc­tor did what he could un­der the cir­cum­stances. Next day

On the sixth day Reshma found that while she was feed­ing Mujahid, he sud­denly turned blue and started gasp­ing for breath. She raised shouts and her mother came run­ning to her.

the doc­tor called the par­ents of the child to his con­sult­ing room and told them that the child will have to be op­er­ated upon but the surgery was del­i­cate and it could be per­formed when the child was about six months old. Reshma broke down and be­gan to cry loudly. The doc­tor pre­scribed medicines and the child was brought home. Bil­lal told Reshma's par­ents to take care of Reshma and the child and the med­i­cal ex­penses. The doc­tor had also ad­vised both Reshma and Bil­lal that be­fore they go for the sec­ond child they should get them­selves thor­oughly ex­am­ined and checked.

eshma took the child to the doc­tor almost ev­ery day for three months till one day Mujahid breathed his last in the arms of his mother. The grief of Reshma knew no bounds. Tears would not stop flow­ing down her cheeks. She went into deep de­pres­sion. She did not speak to any­one. Her prayers were long and silent ask­ing for.

Six months af­ter the child's death, Bil­lal along with his close friend Habib went to the house of Reshma's par­ents. Habib said that they were sorry for what had hap­pened and that they had come to take Reshma to her mat­ri­mo­nial home. Reshma's par­ents showed their re­luc­tance to send away Reshma in the state in which she was. Reshma, how­ever, came for­ward and said that she would like to re­join her hus­band. Ac­cord­ingly, Reshma packed her clothes and other be­long­ings and she ac­com­pa­nied her hus­band and Habib back to her mat­ri­mo­nial home.

nce with her hus­band, Reshma tried to over­come and to for­get her grief by get­ting in­volved in the house­hold work. But her heart­less sis­ters-in-law did not spare any op­por­tu­nity to taunt her and to pierce her with darts of crit­i­cism.

Two months later, Reshma felt ill. She was vom­it­ing, had lost ap­petite and was men­tally dis­turbed. She was taken by her mother-in-law to a lady doc­tor Dr Sulekha Pan­dit, a gy­nae­col­o­gist. The doc­tor ex­am­ined her thor­oughly and opined that Reshma was once again preg­nant. Look­ing to the past his­tory of Reshma hav­ing de­liv­ered a child with a heart de­fect, the doc­tor ad­vised that further tests be done to rule out any ab­nor­mal­ity in the foe­tus. Reshma im­me­di­ately agreed to such tests be­ing car­ried out, but Bil­lal said that no such tests were nec­es­sary as spe­cial of­fer­ings had al­ready been made at the shrine of Ajmer Sharif and all would be well.

On this oc­ca­sion, Reshma was sent to her par­ents when she was just two months preg­nant. Reshma reg­u­larly vis­ited the pre­na­tal clinic to en­sure that the child she was car­ry­ing was nor­mal. Bil­lal did not con­tact her in any­way. A month there­after, Reshma ex­pe­ri­enced pro­fuse bleed­ing. Her par­ents rushed her to Dr Sulekha Pan­dit. The doc­tor ex­am­ined her and found that the foe­tus had slipped the womb and that ter­mi­na­tion of preg­nancy was nec­es­sary or else Reshma's life would be en­dan­gered. Reshma and her par­ents con­sid­ered all op­tions. Reshma's fa­ther tried to con­nect Bil­lal, but some­how the calls could not go through. The doc­tor said that there was no time to lose as the bleed­ing was pro­fuse and con­tin­u­ing.

Reshma then told the doc­tor to carry out the ter­mi­na­tion of preg­nancy. She signed the pa­pers. The doc­tor car­ried out the pro­ce­dure. Bleed­ing stopped and Reshma was saved. Later, Reshma’s fa­ther was able to con­tact Bil­lal and told him of what had tran­spired. Bil­lal was in a fury. He al­leged that Reshma had de­lib­er­ately got his child aborted. Reshma's par­ents pleaded with Bil­lal not to think in that man­ner and the doc­tor had to per­form the ter­mi­na­tion of preg­nancy in an emer­gency to save the life of Reshma. They re­quested him to meet the doc­tor and get the facts con­firmed. But Bil­lal would not be con­vinced.

ix months later, a meet­ing of the mem­bers of the com­mu­nity was ar­ranged by Bil­lal's par­ents on a Sun­day in a hall to thrash out the im­passe that had de­vel­oped be­tween Bil­lal and Reshma. Both Bil­lal and Reshma were also present at the meet­ing. Be­fore the meet­ing could be­gin, an el­der sug­gested

Bil­lal shouted in anger in the pres­ence of all gath­ered: "Reshma I give you ta­lak; Reshma I give you ta­lak; Reshma I give you ta­lak. Reshma; you are no longer my wife."

to al­low the boy and the girl to talk the mat­ter over separately in the room ad­join­ing the hall. This was ap­proved by all. So, Bil­lal and Reshma went to the room ad­ja­cent to the hall.

il­lal was all anger. He be­gan to al­lege that Reshma had de­lib­er­ately aborted his child. Reshma tried to tell him that it was not so and the med­i­cal records would speak for them­selves. How­ever, Bil­lal was not pre­pared to hear any­thing more. Within 10 min­utes, both of them came out of the room and be­fore the gath­er­ing. With­out missing a beat, Bil­lal shouted in anger in the pres­ence of all gath­ered: "Reshma I give you ta­lak; Reshma I give you ta­lak; Reshma I give you ta­lak. Reshma; you are no longer my wife."

Some peo­ple got up and tried to calm him down, but he pushed them away and said that he had done what he had de­cided to do, The meet­ing ended. Reshma and her fa­ther re­turned home. Four days later, Reshma re­ceived by postal ser­vice a ta­lak­nama in writ­ing signed by Bil­lal and his wit­nesses, and also a fatwa signed by a mufti that ta­lak given even in anger was a valid ta­lak.

Reshma's par­ents felt as if their lives had been shat­tered. Reshma, how­ever, sur­pris­ingly ex­pe­ri­enced a sense of re­lief and free­dom.

Reshma's fa­ther made an at­tempt to ap­proach the pres­i­dent of their com­mu­nity to get the di­vorce, re­versed. The pres­i­dent told him in no un­cer­tain terms, that this was not at all pos­si­ble un­der the law. More­over, Bil­lal and his par­ents were al­ready busy find­ing an­other girl for Bil­lal, a girl who would bring a fat dowry, a girl who would not ask for Med­i­cal tests of Bil­lal, and a girl who would choose to die rather than abort her hus­band's child in the womb.

To Reshma, it ap­peared as if sud­denly her eyes had been opened to the in­jus­tice of the en­tire sys­tem. She re­alised that all along she had been treated by her hus­band, his par­ents and even by her own par­ents like a slave, like a piece of fur­ni­ture, like a ro­bot. Reshma de­cided that now she would take her own de­ci­sions and make her own life. First of all she spoke to her own par­ents. She pleaded to them to sup­port her in her de­ci­sions and not to force her into mar­riage again.

eshma's par­ents were awed when they looked into her face full of con­ti­nence and de­ter­mi­na­tion. They too had suf­fered hu­mil­i­a­tion in the com­mu­nity and wanted to raise their heads in de­fi­ance. Reshma's fa­ther told her, "Don't worry, beta, we are with you. We will sup­port you in what­ever you do. We know you will never take a wrong step."

Reshma joined tuition classes to com­plete her ed­u­ca­tion. She wanted to ap­pear for SSC ex­ams. Next, she ap­proached Nazir Me­mon, a lawyer whose daugh­ter had been her class­mate. Mr Me­mon heard her story pa­tiently. He asked her whether she was keen to re­join Bil­lal. Reshma replied that she had been treated like a slave by Bil­lal and his fam­ily, and so, un­der no cir­cum­stances would she go back to Bil­lal. Mr Me­mon then ad­vised her, first of all, to take back all the da­hej ar­ti­cles and her be­long­ings from Bil­lal now that the di­vorce had be­come fi­nal.

Ac­cord­ingly, Reshma's fa­ther made a re­quest to Bil­lal and his fa­ther. A day was fixed when two cousins of Reshma went to Bil­lal's house on the agreed day. Reshma's clothes, gifts and uten­sils and her other be­long­ings were placed be­fore them. Bil­lal and his par­ents did not pro­duce Reshma's gold and sil­ver or­na­ments. They al­leged that she had al­ready taken away the or­na­ments. This was not true. A list of the ar­ti­cles was pre­pared and signed by both the sides.

Reshma then went to Mr Me­mon. He drafted a pe­ti­tion on her be­half un­der the pro­vi­sions of Sec­tion 3 of the Mus­lim Women (Pro­tec­tion of Rights on Di­vorce) Act, 1986. The pe­ti­tion was filed in the con­cerned mag­is­trate’s court. No­tice was is­sued by the court against Bil­lal. Bil­lal and his fam­ily be­gan a cam­paign against Reshma and her par­ents. They be­gan to speak to other mem­bers of the com­mu­nity con­demn­ing Reshma for ap­proach­ing the court. They said that it was highly dis­grace­ful for a Mus­lim woman to step into a court of law and to file such a pe­ti­tion. Never be­fore had any di­vorced lady of the com­mu­nity dared to step into any court. Bil­lal and his par­ents ap­proached the pres­i­dent of their com­mu­nity to pres­surise Reshma to with­draw her pe­ti­tion from the court. The pres­i­dent of the com­mu­nity told them that he would con­sult his own lawyer friend and de­cide there­after.

our days later, Bil­lal and his fa­ther again met the pres­i­dent. The pres­i­dent told them that his lawyer friend had told him that the pe­ti­tion filed by Reshma was ab­so­lutely le­gal. The pres­i­dent told Bil­lal and his fa­ther that ear­lier Reshma's fa­ther had ap­proached him to get the di­vorce re­voked but that he had told Reshma's fa­ther that this was not pos­si­ble un­der the law as the di­vorce was ir­rev­o­ca­ble. The step taken by Reshma was as per the law of the coun­try. So, the pres­i­dent said that he could not do any­thing in the mat­ter. He told them that just as he had ad­vised Reshma to abide by the law, sim­i­larly Bil­lal and his fa­ther should also re­spect the law and to re­solve the is­sue in the court.

In the pe­ti­tion, Reshma had prayed for pay­ment to her by Bil­lal, of the id­dat main­te­nance amount of Rs 30,000 and a rea­son­able and fair pro­vi­sion for life, of Rs 10,00,000. She also

The judge while pro­nounc­ing his judg­ment ob­served that the Act un­der which the pe­ti­tion had been filed did not con­tem­plate the rea­son why the talaq was given by the hus­band.

Dr. Nee­l­ima Gupta Sr. Con­sul­tant Fer­til­ity & IVF, Mi­lann Fer­til­ity Centre MBBS, DGO, DNB, FNB (Rep. Med.) Dr. Nee­l­ima Gupta Sr. Con­sul­tant Fer­til­ity & IVF, Mi­lann Fer­til­ity Centre, MBBS, DGO, DNB, FNB (Rep. Med.) E-mail: in­fodel@mi­lann.co.in, Mob: +91 981

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