Thursday, Dec 26, 2002
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By S. Nagesh Kumar
Drafted by the Indian Council of Medical Research (ICMR), the guidelines clearly lay down minimum benchmarks for infrastructure requirements in IVF clinics, code of practice and proper training for gynaecologists specialising in assisted reproductive technology (ART).
The issue of regulating ART has gained importance as fertility clinics have mushroomed in India seeking to attract infertile couples estimated at 10 to 15 per cent. Some make incredible claims through high-pitch publicity about curing infertility and are often accused of overcharging.
The ART technology has advanced so rapidly that doctors commonly speak of working on six and eight-cell stage of embryos which are less than three days old. Moreover, IVF clinics are considered a key source of 14-day-old embryos needed for stem cell research which the Government wants to encourage.
Among the proposals of ART guidelines are a ban on sex selection and on use of sperm donated by a relative or a known friend of either wife or husband, preventing a relative or a person known to the couple from acting as surrogate, ban on human cloning for delivering replicas and right of children to information about their biological parents or surrogate mother.
Drafted about two years ago in collaboration with the National Academy of Medical Sciences, these will be incorporated into legislation and tabled in Parliament in the budget session, according to Kamini A. Rao, previous president of the FOGSI. She is also a member of the 19-member expert committee constituted to formulate the `national guidelines for accreditation, supervision and regulation of ART clinics in India.'
Dr. Rao, who was here recently in connection with the 46th All-India Congress of Obstetrics and Gynaecology (AICOG) in Bangalore where emerging issues like stem cell research and cloning will be discussed at sessions on infertility, told The Hindu that the FOGSI wholly supported the concept of accreditation of ART clinics on the lines of NABL certification for diagnostic labs. This would ensure quality care, essential since ART has a low success rate of 30 per cent, even in the best of hands.
Noting that public knowledge about fertility-related issues was low, she said all infertile couples did not require IVF treatment and could have children by using infertility drugs too. Research into the causes of infertility showed that men were responsible in 40 per cent cases, women in another 40 per cent, both in 10 per cent while the reasons in the remaining 10 were unexplained.
Dr. Rao said the FOGSI would show unequivocal commitment to ART guidelines as it did for the PNDT (Pre-Natal Diagnostic Testing) Act when it asked all its 17,000-odd members not to perform sex-determination tests and threatened to remove from the primary membership those found practicing it.
She said the federation would play a more pro-active role on ethical and social issues connected to obstetrics and infertility. However, she said the responsibility of strict implementation of the PNDT Act rested equally on the society through measures such as making school curricula gender-sensitive.
She welcomed the move to incorporate a clause in the PNDT Act providing for punishment even to a woman undergoing amniocentesis as she did not wish to have a female offspring.
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