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
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.