Demystifying IVF – ‘A new hope for childless couples’ says Dr. Koradia

The inability of couples to conceive a child has a lot of anxieties and social stigma and it is best for couples to visit an IVF specialist to find out the cause of the issue before even deciding on the strategy. Once it is decided to have an IVF then comes the challenge of whom to trust where to get the right information and cost etc.

In order to get all this information our correspondent interviewed Dr. Rajesh Koradia in MIRA Hospital and IVF center here are the most frequently asked questions and their answers given by the Doctor.

1. What is the percentage of couples in Urban and Rural India who are unable to conceive a child?

From the overall population, around 15-20% couples face challenges in conceiving. This percentage may be a little higher in the urban areas and a little lower in the rural areas. The reasons for higher instances of infertility in urban areas are stressful lifestyle, unhealthy lifestyle, career orientation, less sexual frequency, tubal problems in females caused due to sexual promiscuity etc.

2. What is the percentage of issue in male and female?

Most of the couples we come across try to know who is at fault, is it the husband or the wife? Approximately 40% of the cases, wife is responsible, 20%-30% of the cases husband is responsible and remaining can be overlapping where both husband and the wife is responsible. So in short, we can say that 50% cases, the male is responsible in some or the other way for infertility. However, in the current social scenario very few males accept that they could be responsible for infertility and hence a lot of times they are hesitant towards investigation, they hesitate to accompany their wife for the treatment which gives more stress and trouble to the wife and the compliance of the treatment is not maintained just because of the non-cooperative nature of the husband.

3. Which are the top 3 reasons of inability to conceive?

The most common reasons in no particular order are:-

A)Male Factor (where the sperms are in a very compromised position and of poor quality.)

B)Tubal Factor (where the tubes of the female are blocked or damaged or not functioning normally)

C) Polycystic Ovary

D) Endometriosis

4. What are the possible frauds and how to beware of them?

There are a lot of marketing gimmicks going on in the IVF industry and many IVF centers try to inflate their success figure. One of the most common frauds to inflate the success figure is that the centre indulges in unethical practices by sharing gametes, embryos without the patient’s knowledge. Many centres also do not keep transperancy in their pricing and have huge false advertisements promoting IVF cycles at a certain cost which have many other hidden charges.

It is really imperative that today’s IVF specialists develop the honesty and transparency to not share any kind of genetic material without the consent of the patient first. Strict protocols should be in place so that unintentional mixing or sharing does not take place. Also patient should discuss with the IVF consultant beforehand that they might go for genetic testing when they conceive. This acts as a good deterrent for the fraud. Also patients should ask for the complete costing of the IVF cycle including the medicines and injections etc. and get mislead by the false advertisements.

5. What are the myths or issues surrounding the sensitive subject of infertility in Urban and rural India?

Different people have different nature. Some of the people are shy to disclose that they are facing some challenges in conception and hence they do not want to share it with anybody. There are also people who conceive with the help of IVF but refuse to disclose the same because there are different reasons/logic behind it. For example some think that if their family members or close ones get to know that they have conceived using IVF treatment, then they might think that the baby is not their own, the donor is different, facing the relatives on failure of cycle and lot of other thoughts might crawl up their minds. Some people are worried about conceiving babies with deformity/abnormality through IVF, some are worried about the side effects of the hormones given for the treatment. On the other end some people come to us thinking that IVF treatment is 100% successful. We get patients with all kinds of preconceived notions and mental blocks. Through our counselling we try to lead them on the right path towards pregnancy.

6. What is the cost of an ivf and what is low cost ivf?

Broadly speaking, the IVF cost at our centre depends on the injections used, quantity of the injections used, symptoms of the patient i.e. poor responder, normal responder etc. The most economical way is enrolling in our IVF package in which we transfer frozen embryos (which gives higher implantation rate). Also we have personalized stimulation protocols according to the patient being poor responder or a normal responder. From all the embryos formed, in the package we conduct up to 4 transfer cycle for the patient if she is a normal responder i.e. the patient can take chance 4 of 4 cycles of IVF, and if the patient is a poor responder, we include 4 Ovum pick up in the package and then transfer whatever embryos formed. This is the most economical package we offer.

As far as the cost of IVF goes, the average cost of IVF is Rs. 50,000/- and another Rs. 45,000/- to 50,000/- for the injections. If more embryos are formed, on failure of the first cycle, the injections cost in the subsequent cycle will be omitted. In a nutshell, complete cost of 2 cycles should be around Rs. 1,50,000/- approx.

7. Is it advisable to have ivf in a normal couple to improve genetic DNA?

This is not completely true. In natural conception, the nature works in such a way that the best sperm fertilizes the egg. There is absence of any type of selection. In IVF too, no type of genetic testing is undertaken when the sperms are picked up for ICSI (procedure where the sperm is injected into the egg). Genetic DNA remains the same and therefore the congential deformity probability also remains the same. Couples may sometimes choose to go with donor sperms or eggs in certain cases where they wish to protect the baby from certain hereditary disorders.

8. What is your advise to couples after marriage?

In case of newly married couples, various tests like for example Rubella should be done and appropriate action should be taken to correct them, Supplement Deficiency should be taken care of i.e. folic acid, omega 3 fatty acids etc., avoid junk food to avoid weight gain as it causes problem in conceiving later on, use barrier contraceptive measure and avoid medical termination of pregnancy (abortion) as after every abortion chances of conceiving reduces by approx 5%. Husband should avoid working near hot areas, working near a furnace, prolonged riding on bike, wearing tight underwear, excessively hot water bath etc. All these are the preventive measures.

9. What are the key reasons or USPs of your clinic?

One of the key USP of our IVF Centre is our success rate. According to the MCI guidelines we cannot claim a success rate higher than the statistical average. But since you have asked me, let me share with you that our success rate is on an average above 60%. This figure is open for anyone to come and verify from our records. Second is the trust our patients have in us. We never share any kind of genetic material without the patient’s consent because our focus is not to increase the success rate artificially, but to work towards our mission of “Childless None” where all intending parents should get the joy of parenthood. Further to that mission, expenditure for IVF at MIRA IVF is probably the least in all of India. And for patients who cannot even that charges, we offer discounts, payment facilities, instalments etc. Non affording patients at MIRA IVF are offered an option of paying just for the injections every cycle and we collect our charges when the patient has conceived. Such is the confidence we have on our results. Personal attention to each and every patient is something which we deliver. Each and every patient is counselled personally by me personally. The protocols to be followed, stimulation schedule etc. is all decided by me for each and every of my patient. Embryological procedures are taken care of by my daughter Arwa Koradia who is an excellent embryologist. Thus as a team, we work as a two point contact for the patients. Patients can directly contact her for any embryological aspect query and me for any clinical aspect query. This accessibility to us provides a continuous updation and support to our patients.

Sometimes some endoscopic procedure may be required as a part of the treatment for infertility. To cater to this, a state of the art endoscopic OT with all imported high end equipments has been incorporated in MIRA IVF since a long time. All endoscopic surgeries are also undertaken by me personally and we are not dependent on any visiting surgeon. Thus we act as a one stop solution for all aspects of infertility treatment.

10. What are your future plans?

I wish to start Community IVF Centres in various parts of the country in association with the local Gynaecologists who want to start an IVF centre but are too busy with their Obstetric and Gynaecological work or are worried about delivering results. In this Community IVF centre, I wish to take them as partners. They can bring their patient, learn and then later on start practising themselves. By using a shared IVF lab, the cost of IVF also reduces significantly, thus benefitting the patients too. By these Community IVF Centres, I want to reach as many infertile couples as possible by bringing the cost of IVF further down and make it even more affordable.”

For many couples, conception moves from the bedroom to the laboratory. In the future, 30% of the babies may be conceived using IVF. Today, in vitro fertilization (IVF) is practically a household word. But not so long ago, it was a mysterious procedure for infertility that produced what were then known as “test-tube babies.” Unlike the simpler process of artificial insemination — in which sperm is placed in the uterus and conception happens otherwise normally — IVF involves combining eggs and sperm outside the body in a laboratory.

India has one of the largest and fastest growing private health sectors in the world and is one of the most established and popular destinations for fertility treatment. MIRA Hospital & IVF Center was conceived by Dr. Rajesh Koradia and Dr. Dipti Koradia, with the endeavor of providing state of the art mother & child care facilities to the patients in Mumbai. Safe Motherhood is the guiding force and thought behind every step of MIRA hospital with about 30 Years of expertise in the field of Maternity, Gynecology and Infertility.