Doctors blame erratic lifestyle

In Pune there are around 15 IVF clinics attached to hospitals and a few stand alone ones.

In agreement with Shinde,Dr Sanjay Gupte,former president of the Federation of Obstetric and Gynaecological Society of India and director of IVF centre at Gupte hospital,said there is a huge dip in the female fertility after 35 years.

“Due to their hectic pace of life the couples don’t have time for each other and after two years of marriage they suddenly think of having a child. Since it gets too late by then,we have to help them re-establish the coital function or else advise therapy.” said Gupte.

However,he cautions his patients before availing the IVF treatment.

“Patients need to have patience and faith in their doctors. The success rate of IVF by and large is 40-50 per cent,” said Gupte who treats 150 couples seeking IVF every year.

For Dr Rajesh Balakrishna who runs “Oosite” IVF centre in Pune,75 per cent of the patients who avail In Vitro Fertilisation (IVF) treatment are urban professionals working in the IT or BPO sector. “Most of the couples are so determined about their careers that they are happy to sacrifice married life or bringing up kids together. Generally,couples are in their mid or late 30s and have researched enough about IVF and directly ask the doctor to start treatment as they don’t want to wait any longer,” said Balakrishna.

According to Dr SunitaTandulwadkar,chief of Ruby Hall Clinic’s IVF Endoscopy Centre,there is an awareness about infertility treatment and other available options. All,however,do not require IVF. In fact,simple treatment like inducing ovulation,endoscopic surgery,removing tubal blocks can assist in the pregnancy process.

However,male infertility is difficult to treat. At Ruby Hall Clinic,the IVF centre has now availed of a new technique called intra-cytoplasmic morphologically-selected sperm injection (IMSI) that can double the chances of a successful pregnancy. The machine is expensive but IMSI involves examining the sperm under a high magnification microscope than the standard laboratory equipment to select those with a shape and size that indicates good genetic quality. The best looking sperm is then injected into the eggs,she said.

“It is a trying time for couples as they have to visit the doctor regularly as it requires daily monitoring,” said Tandulwadkar. The woman has to visit the doctor from the eighth day of menstruation till ovulation and injections are given daily for ten days.

According to the natural cycle one egg is released every month. However,in the IVF procedure at least 7-10 eggs need to be released every month,she said,adding that at their centre they have at least 400 couples undergoing IVF every year.

IVF consultant Dr Sanjeev Khurd admits that there is a trend of well-to-do couples coming in their late 30s for conceiving a child. “We have seen patients who work odd hours and then hang out with friends after their work,smoke and drink regularly and suffer from diabetes and hypertension. Once age catches up,they realise it is time for therapy and while it works for some,it does not for others,” she said.

Shinde who has set up the Andrology department at Deenanath Mangeshkar hospital’s IVF centre says that the thrust is on male counselling. “I have to keep aside time to talk to men and tell them to provide semen samples. There are several situational difficulties that we face and it takes several sessions of counselling before they can confide in us,” said Shinde.

Boys want to know why they are sterile,said Shinde,who has counselled several from the IT and BPO sector.

“They realise they have a crisis on their hands and prefer to talk to friends if they cannot bond well with their wives or parents. Obesity is a huge problem and I have examined men with unnatural breasts. Smoking and consumption of gutka is also on the rise among these youngsters who visit our clinics for treatment,” said Shinde.

Dr Avinash Phadnis,managing director of Oyster and Pearl Hospital and among the oldest IVF consultants in the city to introduce the technique said the late age marriage and postponement of child is a trend today. Reducing sperm counts due to sedentary lifestyle and consumption of tobacco is also on the rise. About ten per cent of couples seek IVF treatment after failure to conceive.

There are various factors that lead to infertility. An IVF treatment would be faster if the woman has tuberculosis of the tubes or if there is a borderline sperm count one would try alternative treatments like intra uterine insemination (IUI). Doctors put the range of IVF cycles to around 1000-1200 per year. “It is not possible to generalise because there are different types of IVF – natural cycle,ovulation stimulation,frozen embryo cycle and others – the costs vary beween Rs 20,000 and Rs 1.25 lakh,” said Phadnis.