India needs to have a regulatory process for foetal reduction procedures as it now involves the use of several embryos. A regulatory system exists in United Kingdom and some countries in Europe where the stringent system calls for use of one or two embryos only.
Speaking to Pharmabiz.com, Dr. Mehroo D Hansotia, a leading in-vitro fertilisation (IVF) specialist who has been practising for the last 20 years in India expressed her dissatisfaction on foetal reduction, which is unethical in medical science. "What cannot be accepted is the use of multiple embryos used in the IVF. That is why it is considered 'unethical' in many countries in the West except by the US where a minimum of 6 embryos are used for the IVF procedure. Another point to be noted is that the reduction of embryos causes a 12 per cent risk for abortions.
In India, the clinics offering medically assisted reproductive techniques are on the rise. There are guidelines laid down by the Indian Council of Medical Research (ICMR) and the Medical Council of India (MCI) which are not viable to follow as it calls for at least a minimum of 12 areas identified for conducting the tests, she pointed out.
According to Dr. Kanti Bansal, head of Safal Infertility Clinic Ahmedabad, foetal reduction is a serious issue and the West scorns at the practise, which is existing in India.
Some of the leading gynaecologists and infertility specialists in India and abroad who were present at the 18th Asian and Oceanic Congress of Obstetrics and Gynaecology (AOCOG) here in Bangalore expressed the concern for foetal reduction. They were of the view that government of India needs to take a close look at the issue, which is causing a lot of hue and cry by the doctors in the West.
Dr. Rohana Haththotuwa, a senior OB & Gy from Sri Lanka was considered about the foetal reduction at IVF centres in India as Sri Lanka followed in the steps of United Kingdom law, which advocates use of three embryos. "We just cannot compare our medically assisted reproductive methods with those performed at clinics in India. Government of India has to immediately deal with the issue, " he said.
Infertility management is not dealt as a serious issue here in India, opined Dr. Hansotia. Doctors are keen on IVF training to have a better comprehension of the procedures. "When patients under go IVF spend considerable amount of money only to experience abortions due to foetal reduction. If doctors are sufficiently trained and confident, multiple foetal reduction is not required," she added.
While the West is of the view that with a population explosion in India, there is no need for so many fertility centres. There are 15 to 20 million infertile couples in the country and doctors in India feel that there is need for high technology assisted reproductive techniques.
In India, there is no proper infrastructure and lack of after sales service for the imported equipment and that is also a major problem faced by the clinics as much as the foetal reduction, said Dr. Mridubhashini Govindrarajan from Chennai.
The World Bank has called for a standardisation of infertility clinics and the need for this is imminent in India under the current circumstances, said Dr. Hansotia.
Infertility treatment is an expensive proposition and costs about Rs. 50,000 per cycle, said Dr. Bansal. There is a need to follow the economics in treatment to bring down the cost.
There is no recognised IVF course in even in DNB. The MCI now calls for infertility specialists to start training in their centres as a continuing medical education programme. Though the infertility treatment is a super speciality area of medicine today, the lack of training hampers further growth and awareness more so about the foetal reduction practises, informed Dr Hansotia.