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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.
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