Monday, 12 September 2016

Doctors raise concerns about India’s booming IVF industry

Doctors raise concerns about India’s booming IVF industry

For parents desperate to have a child through IVF, a trip to India can seem like the magic solution to an expensive, painful problem — falling pregnant later in life. Triumphant headlines celebrating the birth of babies to elderly Indian women — see “Indian woman in her 70s gives birth to healthy baby boy” or “70-something woman gives birth and she’s even breastfeeding” — continue to perpetuate the country’s reputation as a mecca for IVF successThe industry is largely unregulated and a single IVF cycle costs around $2000, compared to $10,000 in Australia.

Fertility Society of Australia president Professor Michael Chapman says he has seen many Australian couples come back from India with IVF success“The appeal is in the price, the lack of regulation and it’s easier to get access to donor eggs,” he said. “There have been success stories from there, but they are needles in haystacks. Often the doctors have been to see one IVF clinic and think they can do it themselves. The standards are very questionable. “Every obstetrician and gynaecologist calls themselves a fertility specialist. They do 10-15 cycles a year and say ‘I can do IVF’, but they’re using scientific staff who are not trained properly.”

Daljinder Kaur, 72, gave birth to a baby boy in April after falling pregnant by her 79-year-old husband Mohinder Singh Gill, following fertility treatment at a northern Indian clinic. In 2008, another Indian woman, Rajo Devi Lohan became the oldest woman to ever give birth, when she welcomed her daughter Naveen at age 74.

These families are the subject of a new Al Jazeera documentary India’s Miracle Babies, which explores India’s booming unregulated IVF industry and chronicles the lives of several elderly Indian parents. After 46 years of marriage, Daljinder Kaur and Mohinder Singh Gill were over the moon when their son Arman, meaning hope, was born in April. Arman was conceived with a donor egg and possibly donor sperm — the couple are reluctant to reveal details. “A lot of people used to tell me ‘adopt a child’, but I never felt the urge to adopt or have someone else’s baby,” Kaur told Al Jazeera“The almighty only has made this possible for us. It is his gift ... I want everything for [Arman], that he should become a big man and bring me fame. He has already brought me fame,” she said.

Rajo Devi Lohan, now age 77, is thought to be the oldest mother in the world. She is similarly enamoured with her child, Naveen. “When people used to tease us I’d get angry with them,” Lohan said. “Those who were on our side would say ‘It’s God’s wish. This is your fate and nothing can be done about it’.” But some doctors have raised concerns about the industry’s lack of regulation. They say both the mothers and their children are being put at risk. “Seventy-two years is not the right age to have a baby,” said Dr Narendra Malhotra from the Indian Society for Assisted Reproduction.
“It was shocking yes, science can do it. Science can do a lot of things. 

But it is for the society to decide whether we are going to do things which ... put the patient and the child at great harm. And that is what has happened here. Getting pregnant at 72 is putting a life in jeopardy,” he said. Since giving birth at age 74, Rajo Devi Lohan has developed cancer. She’s had three operations to repair a ruptured uterus and remove several tumours, as well as many rounds of chemotherapy. “Earlier, she was healthy and strong. But after she had her baby, she turned weak. 
Then after a year or two she got cancer,” said Lohan’s family doctor Dr Praveen Sharma. “I feel the treatment she underwent at this age may have caused all these problems, because having a baby at this age means there is some fiddling with the hormones. If you give high dosages of oestrogen to an elderly woman, they’re more likely to have cancer.”

Professor Michael Chapman says the two diseases older people are most susceptible to — diabetes and high blood pressure — can be exacerbated by pregnancy. “A pregnancy is like a stress test for each of these diseases,” Prof Chapman told “The metabolic changes of pregnancy promotes diabetes, which affects both the mother and the baby. The increased circulatory load that a baby processes increases your blood volume by 50 per cent. If you’re 30 that’s fine, if you’re 60, your blood vessels are less likely to cope.

There are also significant emotional risks for the child,” says IVF Australia’s Associate Professor Peter Illingworth. “There is a lot of data on the effects of the child having extremely aged parents,” he said. “The child could have a lot of emotional problems afterwards and is then left looking after old parents at a very young age, or even dealing with possible dead parents.”

Most Australian IVF clinics will not provide any treatment to women over 52, but there is no law in Australia that stipulates an age cut-off. “It’s a deeply personal thing and a law could be discriminatory,” Assoc Prof Illingworth said. For women over 40, the chances of a live birth from IVF is 18 per cent. By a woman’s 41st birthday, these rates drop significantly. Women aged 41-42 have a 5.8 per cent change. For those aged 43-44 it’s 2.7 per cent. If you are over 45, it drops even further to 1.1 per cent, or a 99 per cent chance of failure. Women over 45 are usually advised to undergo IVF using donor eggs from a younger woman.

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