Indian Express,
TS Gopal Rethinaraj

India has not lagged behind the West in the field of medicine but it has to accelerate certain developments which might meet with stiff resistance here. There are certain areas like infertility where many unorthodox clinical practices which have received much acclaim among academicians and practitioners could raise serious ethical questions.

Dr Bert Stewart, scientific director of the Midland Fertility Services, England, who was in the city recently to address a meeting on male infertility arranged by the Malpani Infertility Clinic, said recent developments would help males suffering from severe reproductive dysfuctions to have a baby without any difficulty. "All that is required is a single sperm per oocyte to have a baby," said Stewart explaining the new fertilisation technique practised at his clinic and many other places in Europe.

Speaking to Express Newsline, Stewart said he has been working for many years on 'in vitro fertilisation' (IVF) techniques. But Intracellular Cytoplasmic Sperm Injection (ICSI) is the buzz word today in infertility research and clinical practice.

And Stewart took up this challenging field as soon as it created ripples in the scientific community a few years ago.

The technique is simple and cost-effective, he said. In the case of ICSI, a single sperm is carefully injected into a female egg by micromanipulation technique. Important factors like sperm count and motility are overridden in this case, said Stewart.

Here sperms are taken directly from the tests and are carefully sucked by laprascopic technique using an ultra-fine needle. The sperm thus taken from the man's testes is then transferred to the egg taken from the woman. After two days the fertilised embryo is then transplanted into the uterus thereby initiating pregnancy. The testicular sperms were in fact more effective than the ones present in the ejaculation of such patients, Stewart said. Stewart is encouraged by the tremendous success rate recorded at his clinic. Despite his experience, however, the traditional IVF accounts for 54.4 per cent of the total treatment and ICSI, 45.6 per cent. This year, there is an escalation in the number of patients treated successfully by ICSI, he said.

The technique is highly suited to azoospermic patients, ie, those who have a defective sperm generation process and also to men whose sperms have many dynamical ineffectiveness.

"I don't know how these will be received in India where a lot of sensitive issues are involved," said Stewart.

But there is now an effective method for infertile patients who desperately want to have their own baby, added Stewart.

Stewart who is now in his mid- thirties has the distinction of being one of the two authorities deputed by the British government to inspect and certify the infertility clinics in England.

He graduated from the University of Edinburgh in zoology and then obtained his doctoral degree from Cambridge University.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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