I-26: IVF Scenario in India

The development of assisted reproductive technologies (ARTs) in India began with efforts to create “test tube babies” with in vitro fertilization in the 1980s. But rather than commit public funding to advance such research, the Indian government withheld the use of government funds for research on human embryos, largely as a byproduct of the debate over population control. India with a population of 1.2 Bn and ticking also represents underline a major problem of infertility and it is quite paradox that country with large amount of population also has a large section of people who does not have a child. ARTs encompass various procedures ranging from relatively simple intra uterine insemination (IUI), IVF, ICSI, IMSI, Cryo Preservation and Vitrification. Surrogacy which is not a technique but n arrangement is also included under the umbrella term of ARTs. In India there is an unprecedented and unregulated growth of ART clinics providing IVF procedures over the years within the framework of medical tourism. IVF is the latest addition. Low cost, easy access and easy availability and economical prices of IVF drugs has fueled further growth. India is estimated to be doing currently 80000 cycles per year. To be more precise it is estimated that 70000 to 85000 Ovum pick up and 90000 to 95000 as embryo transfer and it is expected that the growth of IVF in India is growing at the rate of 10-15% every year. The estimated number of clinics in India is almost 500 and going up every day and with such high growth and potential in IVF segment has attracted close attention of the Government. Also easy availability of Surrogate mother, gamete donors have made India a favoured destination for various IVF procedures especially Surrogacy . The resulting surge of the ART Industry in the country has posed a number of ethical, legal, social and moral dilemmas and the Government is working towards bringing regulation in form of all ART regulation bill and rules-2008 which is drafted by Ministry of Health and Family welfare and the Indian Council of Medical Research. It is important and welcome step in the direction. New technology introduced by one clinic is quickly offered by others as a matter of survival. But unlike other areas of medicine, in which new therapies are developed after controlled research in humans, ARTs often are introduced directly from the lab as clinical services for patients. Data are collected as patients are treated with untested new approaches, creating the only area of medicine where patients come for treatment but in reality pay for the privilege of being research subjects. The irony is hard to ignore: The research protection policies applied elsewhere in medical research were driven by efforts to prevent exploitation of the vulnerable—yet patients confronting infertility are often the most vulnerable.There are a few straightforward ways to bring assisted reproduction into the fold. Research in assisted reproduction should receive the same sort of approval and oversight as government funded research. Such policies are long overdue. Bringing ARTs into the open will better serve patients and improve research oversight.