The Baby Boom Town

A PLASTIC baby doll in a swing smiles from the ceiling of the lobby at the National Fertility Centre in Hisar. It is the sum total of the desires,the aspirations of the couples that walk in tempted by the promise of In Vitro Fertilisation (IVF). Age is no restriction here. Motherhood is a limitless opportunity. It transcends all barriersinfertility,age,situation in life.

The plastic babys arms are stretched out,the smile on its lips permanent. It seduces women and men alike. The dangers,the complications then just fade away. In this space,there is no getting into the right or wrong debate. It is only about demand,and the muchness of it.

The National Fertility Centre was established in 2000 in Hisar,Haryana,by Gyanwati Bishnoi,a gynaecologist. She runs the centre with her husband and her doctor-son Anurag Bishnoi,an embryologist. In ten years,the number of couples coming in for IVF has gone up exponentially. From a mere four or five couples,the centre now gets over 100 couples every month.

This is where Bhateri Devi came too. Twice before doctors had transferred two embryos in her uterus. But it didnt work. In the third attempt,they transferred three embryos. All of those fertilised. And on May 29,66-year-old Bhateri Devi from Satrod in Haryana became the oldest woman to give birth to triplets.

At the reception of the Centre,newspaper clippings adorn the walls. Theres the miracle story of 70-year-old Rajo Devi Lohan from Alewa in Jind who gave birth to a daughter in 2008. According to Anurag Bishnoi,she is the brand ambassador of IVF in India. At 70,she is the oldest woman to have given birth. Two years later,Rajo Devis miracle tale dictates directions to her village in Jind. There is the happy picture of Inder Devi who also gave birth to triplets at the age of 48 in 2007. Across the waiting area,is Chameli Devi holding the twins she gave birth to in 2007 at 58. The story in the newspaper charts her painful survival and her miraculous achievement despite high blood pressure.

Almost all stories about elderly women trying the IVF share a similar narrative. Their husbands married twice,even thrice,in their desperation to have a child. Chameli Devi,the doting mother in the three-column picture,was her husbands second wifehis first couldnt conceive. But Chameli Devi was unable to bear children too. Then the couple discovered IVF and all was well,the narrative runs.

For Anurag Bishnoi,the criticisms that it is a health hazard for women at an advanced age to produce babies and that the doctor is being immoral by helping them as it produces dysfunctional families where the child might be orphaned after a few years,are baseless. I am doing it because we can and it is what they want. There is a demand for it. We have the technology.

The rising numbers of people who are resorting to this technique is an indicator of its success and its relevance,he says. It is changing the conservative thinking that women should be blamed for the problem. The attitude is changing. Every woman should have a child, he says.

Bahadur Ram,60,sits hunched in the waiting area of the centre. Hes come from Hanumangarh in Rajasthan with his wife and neighbours to the centre hoping for a miracle. He married twice but none of his wives could conceive. The second wife Lilawati is much younger than him. Ram has tried shammams and babas who promised healthy children in exchange for sacrifices and rituals,doctors who prescribed pills but nothing worked. Then,he found out how other women in his town had got pregnant despite being pronounced infertile. It was the IVF. He bought into it. For Rs 90,000 for the first injection,it was expensive but he went for it.

Hes one of the many across small town and rural India who are buying into the IVF hope. Says Bishnoi,You know they tell me that panchayats here now tell the man to try IVF when he approaches them for permission to marry for the second or a third time because his wife is unable to bear children. But,he adds,he does not guarantee that all women who come to them will be able to bear children.

More than 20 per cent of the women who come to the centre for IVF are above 50. Around 40 percent of them are in their 40s,the rest below 35. At another fertility centre in HisarGovind Fertility and Research CentreDr Manju Khurana says they dont encourage women over 40 years of age to go for IVF. While the donor eggs used are of a young,healthy woman,there are concerns that pregnant post-menopausal women face an increased risk of heart attack,stroke and haemorrhaging.

There is technology available but with technology there is the question of responsibility, she said. Imagine a child who will have to grow up knowing their parents are not there for long. It is a very selfish thing. It also has initiated a dangerous trend. The government must intervene,set up a cut-off age,an upper age limit. The guidelines are ready and they will be submitted soon.

AT the Java Hospital in Hisar where Bhateri Devis triplets are kept in the ICU,her husband Deva Singh,70,is in celebratory mood. He has gifted her a pair of bangles after she gave birth to the triplets. She told me even if she dies while doing it,it is worth the try, he says. It was Bhateri who asked me to marry twice. For them,adoption was never an option and surrogacy is not acceptable to villagers of Haryana.

But in creating life,66-year-old Bhateri Devi almost lost her own grip on it. On the night of her operation,she was moved to the ICU and according to doctors was put on the ventilator. The triplets emerged one after the other. Bhupinder,Isha and Bhupesh are premature babies born one-and-a-half months before they were due. Bhateri Devis bleeding stopped eventually. But it took its toll.

She drags herself to the ICU,where the triplets weighing 1.2 kg,1.1 kg and 780 gms are kept,to feed themshe has to feed them every two hours. Outside in the hospitals lobby,a crowd of journalists and locals have gathered to see her. She lashes out at the media. She doesnt want the attention. All she wants is her babies to put on some weight and to return to Satrod,her village,and celebrate. Of course,that would also mean more loans. Already her husband has taken a loan of Rs 7 lakhs from a cooperative bank in Hisar,mortgaging his land. But its worth it,he says.

IN another village,a 72-year-old woman is trying to hold on to life. The house in Alewa in Jind is a landmark. This is where the miracle happened. Rajo Devi holds the little fingers of her 18-month-old daughter Naveena,almost gripping them. She isnt prepared to let go.

Rajo Devi Lohan also went in for treatment at the National Fertility Centre but developed complications. Two months ago,she started to bleed again. She had another operation recently. The bleeding has stopped but the weakness persists.

Rajo Devi gave birth to Naveena in November 2008. Baba Ram,her husband,whose second wife Omni too could not have children,sold his buffaloes,his cart,and mortgaged his land to fund the treatment that set them back by Rs 5 lakh. When their daughter was born,they threw a grand party where Baba Ram says,almost 2,500 guests came. Blood is thicker than anything. I am against adoption, he says. I know we are old. But Omni is there. She can take care of her when we are gone.

The family is planning a grand celebration for Naveenas second birthday in November but the loan they took is still to be repaidRs 50,000 still remains. But even the burden of the debt did not curb Rajo Devis desire for another childa boy. But due to complications,her uterus had to be removed.

As her daughter Naveena suckles at her breast,Rajo Devis face lights up. But a few moments later,she collapses on the bed. Naveena runs around her but Rajo Devis frail fingers had already lost their grip.

Paying for treatment in installments

Shubhlakshmi Shukla

WHEN it comes to infertility treatment,it is the small towns in Gujarat who score over the cities of Ahmedabad,Vadodara or Surat. And the profile of the prospective parents has also changedfrom the cash rich NRIs or city dwellers,it is largely the residents of remote villages making a beeline to these centres,where they have the convenient option of paying in installments.

In January 2004,the Central Gujarat town of Anand,made headlines when a grandmother became a surrogate mother to her grandchildren at Akanksha Infertility clinic,the first of its kind case in India. Months ago,it was the North Gujarat town of Mehsana which shot into the limelight when a couple in their fifties became parents of twins at an IVF(In Vitro Fertilisation) treatment clinic.

All that Popatlal Patel (57) and his wife,a primary school teacher Bhanu Patel(53),residents of Motichiri village of district Kutch wanted all their lives was a child. Adopting their elder brothers child was their last resort,till relatives referred them to this new clinic in Mehsana. The couple became the proud parents of twins Arya and Arushi in March 2010 after IVF treatment at Mehsanas only IVF facility,the Srushti Hospital and Test Tube Baby centre.

Dr Jitendra Prajapati (37) chose to return to his hometown Mehsana after post-graduating in gynaecology. Though not trained in infertility treatment,Dr Prajapati boasts of nearly 22 successful cases in three years at his Srushti hospital. He admits that he learned it on the trot,while working at another maternity hospital. I observed that the number of patients with infertility problems is a large chunk and so I decided to branch out.

He rented out space to set up his clinic three years ago and has never looked back since with some cases of patients even from the border areas of Pakistan. The story is no different at Dr Sanjay Gandhis IVF centre in the Deesa town of Banaskantha district where the hopefuls include sweepers,vegetable vendors,teachers etc.

What also helps in running the business is the division of the customers intos rich and poor. Dr Jitendra Prajapati offers a concession for the poor patients,charging rich patients Rs 60,000 and knocking off a generous 20,000 for the poorer ones. A concession that gave new meaning to the lives of vegetable vendor Kanti Raval (47) and wife Savita after a thirty year wait. Without children it was a lonely,meaningless life. Adopting means someone elses baby in the end,our flesh and blood is a different feeling admits a shy Savita.

While doctors running IVF clinics in the cities move around in Mercedes,we have a simple set up which makes it affordable for even the poor, said Prajapati.

Hitting the fertility jackpot

ANJU AGNIHOTRI CHABA

PUNJABS Jalandhar district is witnessing a new boom. The main town in Punjabs Doaba region is seeing an influx of NRIs and foreigners to its state-of-the-art infertility treatment centres. A number of these centres maintain high ethical practices and some have even introduced DNA-ID Check-an infant identification parentage confirmation system,a first in North India.

The Virk Fertility Service Centre at Guru Tegh Bahadur Nagar attracts a large number of people from abroad,particularly the US,Canada,Europe,UK,Australia,New Zealand. The fertility centre,the only one in the country that has IVF CO2 incubators,currently has a waiting list till November.

Dr SPS Virk,a renowned embryologist of North India,who started this centre 16 years back,claims,Our success rate is unmatched. Thats why 60 per cent of the patients are NRIs. He says his centre recorded a 70 per cent success rate in August 2009 as opposed to the 25 to 50 per cent rate worldwide.

But all is not well with this fertility boom town. According to an estimate of the Indian Medical Association,there are 20,000 gynaecologists in North India out of which only 15 to 20 gynaecologists are fertility experts. However,the majority of gynaecologists here claim to be fertility experts and are cashing in on the runaway success of some centres. The Gujral Nagar,Adarsh Nagar,Shaheed Udham Singh Nagar areas of the city are home to a number of them and a visit to most such centres reveals dinghy and unhygenic conditions and substandard IVF laboratories.

The number of people going in for this treatment has gone up ten fold as compared to five years ago. On an average around 10 cases are being received by each such centre.

Khushpreet Dollar Singh,an NRI from Finland in her late 20s,underwent 10 unsuccessful cycles there but finally was blessed with a baby girl in June 2009 at her third IVF cycle at the Virk fertility centre. We visited two renowned centres in Jalandhar but there was a difference of 50 per cent in the cost and then we went for the cheaper treatment here and were blessed with a baby girl, says another Jalandhar-based woman.

We receive nearly 70 to 80 couples every month who want to get IVF treatment just for having a boy but we refused them and also maintain the entire record of such couple as in the past five years we have refused nearly 10,000 such cases, says Virk.