WOW | Viewpoint

Vatsalya Natural IVF

Shristi Khadka
Executive Director, Vatsalya Natural IVF

Someone rightly said ‘One hundred years from now, It won’t matter what car I drove, what kind of house I lived in, how much I had in my bank account, nor what my clothes looked like, But, the world may be a little better because I was important in the life of a child’.

Being a parent means a part of you will always remain alive on earth through your next generation, a blessing many of us take for granted. Infertility is widespread, yet the least talked about issue all over the world. A couple unable to conceive a baby undergoes immense emotional turmoil and social pressure. The social stigma and discrimination attached to it in turn prevents the needy couple to seek the necessary fertility services, further aggravating their emotional trauma. Many cases of multiple marriages, divorce, domestic violence, social seclusion, depression and even suicide has been accounted to infertility, majority of which is suffered by woman in this male dominant society. Infertility is commonly considered a defect in woman’s reproductive system and male factor infertility is largely ignored, while a recent study by WHO (World Health Organization) shows that 33% of infertility can be accounted for male factor infertility.

Counselling an emotionally vulnerable patient is the most challenging part of providing infertility treatment services. Especially when they have already had multiple treatment failures. We try to make them feel that they are not alone in this process and that persistence combined with quality treatment is the key to success. Infertility treatment especially IVF is a pretty expensive process ranging from Rs. 15,000 – 400,000 depending on the severity of the condition. Of course, multiple treatment failure can be financially difficult for the patients. For that we have introduced minimal stimulation IVF and natural cycle IVF which can be done at half the cost of the regular cost of IVF in Nepal.

Having said this, IVF/ICSI is not a sure shot treatment of infertility. Worldwide success rate for IVF is about 35-45% only, the chances of success being higher in younger patients. Therefore IVF should not be considered as the last resort of infertility treatment, which has been the case in most of the patients here, making treatment process more expensive and difficult.

But this doesn’t mean that older patients cannot try to have a child. Depending on the case, they can opt for egg donation, sperm donation, embryo donation or even surrogacy.

Woman after their late 30s often have lower egg reserve as well as poor quality of eggs which makes the fertilisation process difficult. So we have introduced a new plan of ‘egg freezing’. A woman in her late 20’s can freeze her healthy and large number of available eggs at that age and can try to get pregnant using those same eggs in her 30’s to ensure a healthy offspring. Egg freezing is especially very useful for working women who want to delay pregnancy and motherhood and for women with cancer indications and can become a mother after chemotherapy.

People still have a lot of misconceptions regarding IVF and have not been able to fully trust this miracle of science. Most widespread misconceptions that we have heard are that an IVF baby is not a real baby, IVF babies are born with physical deformities or mental disorder, a fully formed baby is made inside the lab, etc. Obviously none of these are true, an IVF pregnancy or baby is as normal as a naturally conceived baby.

We established Vatsalya realising the need of a high quality infertility treatment and care in Nepal which can also be affordable. Vatsalya means ‘the love of a mother/parents for their child’. Our fertility center combines state-of-the-art innovation in reproductive medicine with a multidisciplinary approach to better attend to the physical, emotional and spiritual needs of our patients. Our entire staff is dedicated to helping people move through the challenges of becoming a parent through various fertility treatments. The treatment plan at Vatsalya is carefully designed to correctly meet your needs so as save your time and money and ensure success.

Lastly I would like to urge every couple going through infertility to come out and seek the services available and understand that it is okay to the ‘science route’ towards parenthood.

Dr. Sabina Simkhada
MD, Obs/gynae, Fertility Specialist, Vatsalya Natural IVF

What are the most common reasons for infertility in men and women in Nepal? Which age group do you find having the most problems?

The most common reasons for infertility in men is abnormal sperm parameters (azoospermia, oligospermia, morphologically abnormal sperm, infections etc) while for a woman its mainly PCOD, fibroids, endometriosis, fallopian tube blockage, hormonal imbalance, abnormality in uterine structure or poor ovarian reserve due to advanced age. 10% of all infertility can also be unexplained.

Could a previous abortion or having been on the pill affect fertility?

Yes previous abortions may affect fertility but only in a small number of cases by causing tubal blockage. Similarly woman on OCP for prolonged period may lead to ovarian shut down, making them resistant to treatment.

For how long should a couple try fertility treatments?

Well I would say as long as they possibly can because there are many options available and the treatment procedure can be modified after each failed attempt. Because if you don’t try, your chances of parenthood is definitely 0%.

When should a couple seek medical help when they are unable to conceive?

When the female partner’s age is less than 35 years and has been trying to conceive since a year but there has been no conception. They should seek consultation with a fertility specialist also if the age of a woman is 35 years and haven’t conceived after six months of trying.

Is infertility becoming more common these days?

Yes, infertility has become more common these days. Mainly due to exposure to harmful substances through food, air and almost everything around us. Also because people have become more career oriented and prefer late marriages and pregnancy, and especially women who fail to realise that their fertility clock is ticking!

Apart from this I also feel that we are seeing a lot of infertility cases because people have actually come out to seek the service which in earlier days was not possible due to limited availability of treatment services.

What are the things they should look for when choosing a fertility doctor / centre?

First thing they should look for is a well-trained fertility specialist who can handle various stages of infertility treatment preferably who is based at only one centre so that the doctor can give her full time and devotion towards her patients

Secondly, for IVF the availability of modern technology and a well equipped embryology lab with a well trained embryologist.

Thirdly, the etiquette and behaviour of the medical and non-medical staff, and their ability to correspond and communicate with all types of patients, whether difficult or easy.

Fourth, the environment of the centre. Infertility patients aren’t sick people. It is important that when they visit a centre for treatment, they are made to feel relaxed and well attended. A well maintained, clean and cozy interior enhances the morale of the patients.

How does a person decide what treatment plan is the best option for them?

Every case of infertility is different, the best treatment plan cannot be determined without a check up. People facing infertility issues should consult with a good fertility specialist and undergo a thorough fertility check-up before deciding on what are the best options for them.

What are the medical / health risks associated with fertility treatments?

If treated under proper supervision, there are no side effects.

What are some things a couple can do to improve their chances of conceiving and carrying a baby to term?

A healthy diet and lifestyle is primary. Visit a good gynaecologist and strictly adhere to medical advice.

Fertility treatments often result in twin or multiple births, why is this so?

In IVF it is normal because 2-3 embryos are transferred at a time to increase the chances of implantation.

In IUI and other forms of treatment, multiple births can occur when the medicines used for ovarian stimulation can result in ovulation of multiple follicles instead of one.

What are the options should a treatment fail?

Like I said earlier, there are many treatment options for infertility. Once a treatment cycle fails, we can always learn from the previous one and make modifications in the next. The only thing is that one should not give up because every failure only makes you one step closer to the beautiful journey of parenthood.

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