Dr David Robertson, a noted Dubai-based IVF specialist and group medical director, Bourn Hall clinic, talks to Healthpost about causes, concerns and treatment for infertility. Excerpts…
Why do you think more and more people are going for assisted reproduction techniques?
People are now aware about infertility, its causes and treatment options available. They look for fast solutions to their problem in general and the same applies to the infertility. They don’t wait for long to try IVF.
Causing an increase in infertility is the fact that people go for late marriage--in late 20s and 30s and then wait for another three -four years, until they are financially stable before they plan children. But unfortunately, the body clock does not work that way.
Are the factors causing infertility in India any different?
There are some medical issues which are peculiar in this part of the world. Poly Cystic Ovarian Syndrome (PCOD), for example, is very common in India, Dubai and other gulf countries but you hardly find it in American and European women. I think it is due to some genetic factor. Women suffering from PCOD often find it difficult to conceive naturally and require assisted technologies.
How has the IVF changed over the years?
The basic technique remains the same. The process involves extracting eggs from a woman’s ovary, fertilizing them outside her body in a laboratory with the husband’s sperms and then re-implanting embryos in her womb.
But the quality of medicines which are used to stimulate ovaries has improved dramatically.
These medicines help in extracting better quality eggs which eventually leads to better embryos. It improves the chances of successful pregnancy. I started doing IVF in the 1980s, at that time the average rate of pregnancy was 15 per cent which has now increased to 40 per cent.
However, woman’s age is an important factor. The success rate is high in the 30s and dips in the 40s.
Besides, another important aspect that has changed for good is that 40 years back, people would not accept that a man could also suffer from infertility, forget undergoing treatment.
However, now they come to us as a couple and are open to treatment.
How does lifestyle affect fertility?
What we eat and drink, how we live has tremendous effect on our reproductive health. Growing obesity has an impact on fertility. Processed food is bad for health. There are different kinds of stress—physical, relationship-related, work-related and environmental—affecting people’s health.
I have also observed that drinking alcohol dramatically affects the quality of eggs in women. Women who drink alcohol daily, even if only one glass, have bad quality eggs.
Recently, commercial surrogacy was banned in India. How integral is surrogacy to the assisted reproductive technology?
Surrogacy has its place and is advised in specific conditions. It is the only solution if a woman has a problem in carrying a child in her uterus. But unfortunately, it became a common modality of treatment in India. I feel it has been overused.
What people don’t understand is that having a child is not important only because you want to become a parent, it is also important for a woman to undergo all those physiological, psychological and hormonal changes she undergoes during her pregnancy. Pregnancy is important for her health.
What are challenges of being an infertility specialist?
Fertility has a social, psychological and emotional aspect. A child is very precious for a couple. So, learning the technique is not enough, you have to learn to deal with the other aspects of the treatment as well.
I was a junior doctor when I had to do a one year of research on infertility. I travelled a lot for this research and collected many samples from couples suffering from infertility. My experiences during that one year got me interested.
There is nothing more fulfilling than to be able to help a woman conceive and give birth to a healthy child. I was 24 when a woman in her early 30s came to me. She was trying to have a child for long. I treated her with some medicines and she conceived twins. It was very fulfilling.
But the difficult part of my profession is to tell a couple that they can’t have a baby. As a doctor, I feel helpless when I have to tell a couple that they should stop trying. We cannot treat every condition.
What are your views on egg and embryo freezing?
We extract eggs and fertilise them to form embryos for anyone undergoing an IVF cycle. Some embryos can be saved for later use. The couple does not have to undergo the full process again in case of an unsuccessful pregnancy.
Egg freezing has become reliable in the last 4-5 years.