IVF Clinics mushroom in the absence of ICMR guidelines

July 24, 2018, Dr. Kamini Rao, 32 Comment(s)

According to the estimates of the World Health Organization (WHO), 13 – 19 million couples are infertile in India. This has also led to mushrooming of In-Vitro Fertilisation (IVF) clinics across the country. Even as the stand alone clinics grow without any hinderances, only a few of them are actually enrolled with the national registry of Indian Council of Medical Research (ICMR).

According to their data, out of almost 1500 Assisted Reproductive Technology (ART) centers, only about 385 are registered with them. This is probably because the registration process requires extensive details like the technique of ART they are providing, kind of facilities and manpower and their qualification, licensing of ultrasound machines and other equipment, number of patients per week, the details of the embryologist and other specialists, whether the clinic is doing some genetic study or only IVF. Not all clinics are registering, only the big well-known ones are. These days, people are opening IVF clinics at homes as well. A small gynaecologist’s clinic can easily be turned into an IVF clinic.

Let’s face it.. the outcome of IVF treatments depends purely on the doctors’ experience and efficiency. IVF involves procedures of extracting eggs and sperm and making them fertilized in vitro and then implanting fertilized egg in a woman’s uterus. The task is performed by a multidisciplinary team. There are ethical issues involved in the IVF treatment as we fertilize egg and sperm outside the body. At times some centres use donors’ sperm to fertilize egg in case of low sperm count of the husband. They do so without taking consent of concerned person. Hence these IVF centers fail at providing quality and ethical services. There has to be a regulatory body which monitors the operation of IVF clinics to curb unethical practices.

As fertility experts, we feel that the ICMR has regulatory guidelines. But in the absence of the law, they are ‘toothless’ and only the ART Bill can ensure strict compliance. The bill has been in the works for many years now (the possible reasons for which we shall discuss in another article) but is still awaiting the Parliament nod.

Comments and Replies

  1. Any body can become Ivf specialist. No eligibility criteria. Your leadership may bring quality change madam

    • I think bringing the guidelines into law has to be a collective responsibility. I will definitely continue to contribute as I have done to the ART bill for the last 20 yrs.

  2. What we are really worried about ?is the mushrooming of centres or Work ethics to be followed and a support for new centres!

  3. Government or ICMR alone can’t curb these unauthorised IVF assistance clinics.There should be basic ethical values which needs to be inculcated before entering into profession which has to be addressed immediately, otherwise the preserved values of proffession which has already dented will gradually disintegrate.

      • The root cause of all these uncivilized & unethical practices is today’s system of getting selected into the profession, really certain number of candidates are selected through some government system, and rest of candidates inducted is questionable? How can anybody expect ethical values from them of whom most are like corporate capitalists devoid of any human values & services.once upon a time we could able to get good no of humble natured rural representation ,but the number now is dwindling. The aspirations, priorities of substantial number of present generation is in contrast to yesteryear’s professionals drastically differs hence,we expect mushrooming of unauthorized IVF assisting clinics.Its only tip of iceberg, the order of the day &need of hour required is massive revamp of whole concept of medical education.

  4. Well said madam,In our city we r the only centre who has got ICMR.And we have been validated for Pgd and era by Spain genetics.But many are are mushrooming with no embryogist or no gynecologist,only freelancers.Happy doing 3 or 4 cases.how can anyone maintain standards and quality with such poor volume .like madam said people are starting in just houses or one floor building .How can they do justification without doing pre art work ups ,surgeries Nd procedures which may require during treatment. Most of them are not realistic about the complications or post care.You r treating a women, normal healthy person just for pregnancy and better not to make her a real pt or complicate her health.Qualifications should be defined and strictly monitored.

    • Whilst I agree with Kamini Rao’s thought process re the mushrooming of ART Centers, I do not agree with you Buvaneswari Gangaraju when you question the specialists offering ART Centers in small houses or one floor. Check the results of the Kiel School of Reproductive Medicine which Is smaller than even the small yet leading Centers of ART in Mumbai. Smell the coffee.

      • Prashant Mangeshikar I think quality of service is more imp that that vastness of space. For example the lab and opu. Should be of high quality but the support services like opd scan for follicle monitoring etc can be shared with other depts.

      • Sir I am not talking about IVF department space. The smaller the lab it’s better to maintain and clean.If within the hospital premises all support system in place.but I am talking about individual centre s run and no full-time drs available .we can’t compare international centre because they know the limitations and complete workflow will be planned.all will be well qualified and experienced.here I am talking about quality skills ,and ethics only sir .For the increasing demand we need more centres and drs.But for that we can’t put pt into risk.

    • Buvaneswari Gangaraju Doctors in their private setup be it small or large are responsible individuals. I am not aware who you are or what your setup is, but the fact of the matter is I am proud of the great inputs put in by my FELLOW INDIANS not just in mega cities like Mumbai or Bengaluru but there are great outputs from my fellow colleagues in smaller cities, towns and villages. Remember that the ubiquitous dosa is often tastier and healthier than the ones from five star hotels. You don’t require factory space to produce IVF babies. Maybe Dr. Devi Shetty of Narayana Hrudhralaya May enlighten you on this within your own garden city.

    • Well said sir, Absolutely true , there are specialists striving hard and doing good work to give best results for patients , be it small or big the size doesn’t matter . Is the patient getting the best and appropriate treatment ? That matters the most , as u said doctors are the most responsible individuals, I have worked in large set ups also and now run a small set up ..but the dedication towards the work is the one which makes the difference . I’m proud to have been trained by people like you with great supportive thoughts for the fellow doctors like us . As madam had correctly said we need to regularise art centres , as now with the existing pattern of registration and rules , it’s very easy for anyone for that matter of fact even a person completely with no knowledge on Ivf / art can start a centre , the filtration should start at that level.knowledge and experience is not a shortage among our indian doctors but patients are not directed to the correct centres , which can be done only by regularisation of the art clinics until then the people in real need of such treatment will continue to be lured away into various such places .. waiting and hoping that such Standarisation will happen soon

  5. When I joined my FNB fellowship with Dr B.N.CHakroborty in 2007,we were told that ART bill was pending, today in 2018 it is still pending

  6. Probably you missed the laboratory aspects including the Embryologist’s qualifications and skills.
    I believe the success depends more about 70 percentage is of Embryologist’s skills and 30 percentage on the doctor’s side.
    Usually it’s evident when a new Embryologist join the team, or when moving out.

  7. True. Long awaited ….Hope pioneers like you maam will ensure certain landmark changes much needed for us take this legacy forward.

  8. With a few exceptions ,these so called IVF centers are actually fraud ., Many have put the names of Drs who are not actually present in the city…Dr X Embryologist , Dr Y sonologist , Dr Z counsellor ,with a photo or two showing herself at some hospital in Singapore and claiming to be an IVF expert.

  9. Ma’m very truly expressed but it is very difficult for genuine new entrants to survive as this is no more a science or medicine, some other aspects have entered in it.

  10. Very well said ma’am…ART bill is the urgent need keeping in mind current scenario.
    Long pending ..reasons ????

  11. Kamini Rao! How right you are. Ideally only those who have had sufficient training preferably a university recognised fellowship should run an ART service. Similar to what you wrote, there has been mushrooming of training programs of one week or even three dats by private clinics with no university accreditation in ART as well as gynecological Endoscopy and many are senior members of FOGSI ISAR IAGE etc. There must be curbs before a major crisis occurs. The famous statement: SEE ONE, DO ONE and TEACH ONE seems to be the credo of these experts.

  12. Much needed article/ discussion. Unless accountability and standard of treatment is provided IVF treatment will loose its credibility. ICMR needs to move fast to regulate and make registration process easier with required standards
    Dr Chandra Reddy
    London IVF, Vizag

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