Bangalore Assisted Conception Centre was set-up 10 years ago with the main aim to counsel and treat women who carry the social stigma of infertility. Women have always been the target for ridicule in cases of infertility. I believe that women have the right to decide whether to conceive or not to conceive or resort to contraception. Women are infertile not by choice but by chance. At BACC, we address the causes and treatment for infertility. There are around one billion infertile people and infertility treatment can be expensive. My aim is to cater to the middle class of woman who cannot afford such treatment.BACC is a hi-tech clinic with a qualified panel of doctors, and an in-vitro fertilisation (IVF) programme with a success rate comparable to the best in the world. The centre is also registered with the Government of Karnataka for carrying out genetic counselling and prenatal diagnostic procedures.
What are your focus areas as a member of the Karnataka Task Force Committee? What changes do you expect in the State in this area?
I want to empower women by providing better healthcare facilities. Anaemia is morbid here in Karnataka. It is ironical that women have no access to nutrition, clean water and sanitation. If the women in rural areas were given a better deal during their adolescence for self-hygiene, then they would not have to come to the primary health centres (PHCs) to treat infections and other related disorders. Through the Task Force, I plan to take a closer look at these issues. I have been given an opportunity to serve as an Honorary Consultant in Vani Vilas Hospital, Bangalore. The Karnataka government will soon finalise the proposal for setting up a ''Centre for Excellence'' where my services will be utilised for treating Level-1 infertility disorders. I hope to garner some corporate donations for installing the required equipment like ultrasound etc. At this platform, I will also be able to sensitise the government to the fact that not only should women who are ill be cured but that prevention of ill health is better than cure.
What do have to say on the need for guidelines for infertility clinics?
Guidelines are vital for maintaining highest treatment standards. The most important point is to insist on documentation of procedures by clinics all over the country. Another critical issue is the cleanliness of the clinics, which conduct such procedures. An Expert Group has been constituted by the Indian Council of Medical Research for formulating guidelines on "Accreditation, Supervision, and Regulation of ART Clinics in India". I am a member of this expert group and we are in the final stages of bringing out these guidelines.
Could you comment on the PNDT Act? Are you convinced that the Supreme Court order will help in curbing such practises?
The Indian Government in the year 1994, passed the Prenatal Diagnostic Techniques (Regular & Prevention of Misuse) Act to combat the menace of female foeticide. This act prohibits the misuse of Prenatal Diagnostic Techniques for determination of the sex of a foetus, which could lead to female foeticide. However as we are all aware female foeticide in India continues to be rampant.
According to me, the PNDT Act must be engraved in each doctor''s heart. Only then will we be able to curb this horrendous malpractice of female foeticide. Legislation can only help to a certain extent. All doctors should give up this neutral attitude to prenatal sex determination that we have consistently shown and take a strong stand to curb this practice.
What about drug discovery in fertility? What is the latest medication?
There is a remarkable progress made in the introduction of higher follicular responsive even for endometriosis there is a better response with drugs. New drugs have proved to have a higher recovery efficacy, recombinant HcGs, gonadotropin agonist stimulation tests, have good cycle control.
Are you in a position to comment on the consent by the Central government to use embryos to grow stem cells for infertility treatment?
The introduction of molecular biology techniques, particularly Pre-implantation Genetic Diagnosis is one of the most exciting advances of the last decade. Another line of research is the study of early embryonic development. Can embryos be used for developing tissues or organs for replacement? Stem cells obtained from developing embryos hold much promise in the field of biotechnology. It enables development of more pluri potent cells which can be used to develop bone marrow, treat disorders of the brain and kidney, used in skin graft for burns, replace blood cells for leukaemia and even replace eyes cells'' for blindness.
However, stem cell research in India could be like opening a Pandora''s box. At this stage we are all apprehensive about stem cell research and we need a law for legislating this concept before going any further.
What are the latest advancements in gynaecology and obstetricians and how much of these techniques are adopted here?
There are several modalities like hormone replacement for menopausal women, recombinant drugs for infertility, pinhole and laser surgery etc which are advanced treatment options. India has all these options and more.
Is there a shortage of gynaecologists and obstetricians and what is the first important task to increase the number of doctors?
More than a shortage, there is mismatch of doctors. This leads to a gynaecologist to serve in orthopaedics in rural areas. This needs to be rectified.