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Ranjna Majumdar/ Mumbai
For 56-year-old S Singh from village Barddi near
Patna it was a tough decision. Doctors declared that his sperm count
was too low to impregnate his wife, while social pressures decreed
that he and his wife produce a child soon. So without informing
his family about the real reason of his trip and with many personal
misgivings, he and his wife came to Mumbai and checked into a fertility
clinic. Two months and three cycles later his wife was pregnant
thanks to some donor sperm. While Singh was happy about the pregnancy,
he was honest enough to admit his frustration at not being the biological
father. "It is something that I will have to learn to forget,"
says he.
S Singh like millions of other Indian men
suffers from testicular failure which means that there is no sperm
present in their semen. Testicular failure attributed to undescended
testes, physical trauma to the testes, to mumps and to several other
inexplicable reasons, is the main reason that these men have to
resort to donor sperm. However, research over the past few years
has shown that despite the absence of sperm in their semen, these
men do produce immature spermatozoa in their testes. This immature
spermatozoa, if retrieved and injected into the egg, can achieve
fertilization and normal development of the embryo. "The technique
has revolutionised the whole field of assisted pregnancies,"
says Dr Anirudh Malpani, of the Malpani Infertility Clinic
where the technique was introduced a week ago. The clinic has already
reported 11 successful fertilizations so far thanks to this new
medical procedure called ICSI (Intra Cytoplasmic Sperm Injection).
Under ICSI, sperm or their precursors, spermatids,
are extracted directly from the testis. This is a minor surgical
procedure which is done under local anaesthesia. The testicular
tissue is then processed in the laboratory and sperm are recovered
from these. One of these sperm is then injected into an egg, to
achieve fertilisation. In the tests conducted so far fertilization
rates in the range of 60 per cent have been achieved - which means
that of 100 micro-injected eggs, 60 formed embryos after ICSI. The
pregnancy rate in one ICSI cycle is absent 25 to 30 per cycle ie
chances of an embryo so created after ICSI growing into a baby are
about 25 to 30 per cent "which, says Malpani, "is
the success rate in normal pregnancy."
Talking about the possibility of ICSI taking
over as the preferred procedure over donor inseminations, Anirudh
Malpani says, "Of course all couples would prefer ICSI
rather than DI. But the problem here is of finances, each cycle
costs about Rs 80,000 as opposed to Rs 50, 000 for DI." Couples
like S Singh however are willing to bear the cost, says S Singh,
"If my wife permitted I would like to go in far a second child
using ICSI." It is a feeling echoed by many young couples looking
to add their own bit of eternity to this world.
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