Posts Tagged ‘Assisted reproductive technology’

Do you really need a surrogate ? – Dr.Malpani

As an IVF specialist, I receive a lot of queries from infertile couples from all over the world. Many of these are older couples who have been infertile for many years; and since they cannot get medical treatment in their own countries ( either because it’s too expensive or because their government does not allow it), they want to come to India for treatment. Many of them think that because they are too old, their best option would be surrogacy; and since they have read many articles about how easy surrogacy is in India, they often email me asking for gestational surrogacy services.

The tragedy is that so many infertile couples are still so poorly informed about surrogacy treatment and who it is useful for. Many couples naively believe that a surrogate is the final answer to all infertility problems; and that surrogacy has a 100 % pregnancy rate ! Sadly, this is just not true !

Surrogacy is an expensive and complex treatment option, which is best reserved for women without a uterus, or whose uterus is damaged. Older women who are infertile rarely need a surrogate. As they get older, their fertility declines, not because their uterus ages, but because their eggs get old – a condition called the oopause. Since their own uterus is usually completely normal, using a surrogate makes no sense for them at all ! After all, how can replacing a normal uterus (their own) with a surrogate’s uterus improve pregnancy rates just because the surrogate is fertile and has had babies in the past ? These couples would be much better off considering the options of donor eggs or donor embryos.

Unfortunately, they are often so desperate to have a baby, hat they do not bother to learn that as their biological clock ticks away, it’s the ovaries which get depleted of eggs – not their uterus. Since surrogacy is a lucrative treatment option to offer ( it’s the most expensive of all the IVF treatments offered today) , many IVF clinics are happy to offer surrogacy, without bothering to explain to couples why it may not be the right treatment option for them.

It’s exactly the same situation with couples who have failed multiple IVF cycles; or who have had repeated miscarriages. They are emotionally very vulnerable and are willing to clutch at straws. They have low self-esteem, since their bodies have failed them, and are very happy to explore surrogacy. However, research shows that the reason for failed implantation is much more likely to be genetically abnormal embryos ( because of poor quality eggs), rather than a uterine problem. Even though surrogacy may not be their right treatment option for them, it continues to be overused and misused. This sort of medical abuse it likely to give all IVF clinics a bad reputation.

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Dr.Malpani-What does a mother go through when her daughter is infertile ?

A Comanche Mother
Image by George Eastman House via Flickr

This is a guest blog entry from the mother of one my patients. It offers great insight into the impact of infertility on other family members !

Q 1 What do you feel when you see your daughter go through IVF ?

A There are mixed feelings – of high hopes as well as anxiety. On a positive note, I feel good that with the advances in medicine today we have expert guidance in Infertility Treatment which was not available to the previous generation. So, a ray of hope crosses my heart that there is still a chance for my daughter to conceive and achieve her dream.

Anxiety, that my daughter has to take so many injections and medicines. I can see her emotional strains when two IUI cycles failed after all the efforts put in not to mention the financial loss incurred due to her taking leave without pay from her current company to attempt IVF as also the risk that she may not get her job back.

However, the biggest risk – “What if too much of these injections and medicines end up in pregnancy, but with a child suffering from Down’s Syndrome? Better not to have a child than give birth to one who will face difficulties for life.

Q 2 How does your daughter cope? How does she feel about it?

A I can see my daughter struggling to cope with difficulties and there are quite a few – the main being to reduce her weight.

I admire her commitment to have gone through it all. She could have chosen the easy way out and said ‘No’ to Infertility Treatment. After all, she has crossed 40 yrs. and she knows her chances are low. She has sacrificed her job, left her home in Pune to be under Dr. Malpani’s excellent care in Mumbai.
As a mother, I’ve encouraged her to do her Best and leave unto God the Rest.

It is said that some of our principal regrets in life are the opportunities we passed up and the chances we didn’t take.

Q 3 How do I feel about one child having children, one not?

A Each person has his own Destiny – Karma. My daughter got married at 41 yrs, while my son was quite young when he married , so by God’s grace he did not have difficulty vis-à-vis “infertility factor”.

According to me, the be all and end all of marriage is not just re-production. Sure, grand children are a source of delight and posterity is ensured.
However, I’d rather apply the analogy to marriage that “Oftentimes two people working together find easy that which seems un-surmountable to one alone.”

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