Govt hospital to start infertility treatment by year-end

Coimbatore: Vedha*, 28, who works as a domestic cook, and her husband, Vishwa*, a factory employee, have been undergoing treatment for infertility on and off from 2016.
While they manage to go for intra-uterine insemination three to four times a year, they could afford only one cycle of invitro fertilization in the last three and half years. Even this, the couple manages after investing almost every penny they earn in local chit funds and living frugally.

In what could be a boon for thousands of such couples facing infertility but cannot afford treatment at private hospitals, the Coimbatore Medical College Hospital plans to start offering advanced infertility treatment by the end of the year. Advanced infertility treatment costs anywhere between Rs 7,000 and Rs 1 lakh upwards, depending on the treatment and hormone medications involved. This cost often recurs for every repetitive cycle or treatment, often making it unaffordable for the poor, who often deal with monthly income of Rs 15,000 or even lesser.

CMCH is one of the three government medical college hospitals in the state, including Kilpauk medical College Hospital and Madurai Medical College, where the health department has proposed starting advanced infertility treatment.

In the government hospital, the entire treatment, including the required scans, hormone tests, hormone injections and inseminations will be offered free of cost. Even if GH would only slowly start acquiring all the equipment and infrastructure required, and patients may have to opt for private centres for one or two steps, the cost would still be a fraction of the usual costs. “Though doctors say most couples conceive only in the third cycle, I cannot afford two more cycles of IVF. Once GH starts it, maybe I will go try there,” Sundari S, a carpenter's wife, said.

“We already offer basic infertility treatment including investigations, looking for any blocks in the fallopian tubes, issues in the uterus, treatment for endometriosis, and removing any cysts,” head of the gynaecology and obstetrics department at GH Dr Manonmani said.

“We also give hormone medications, tablets or injections to induce ovulation and stimulation to produce more eggs,” she added.

The hospital does not yet have an andrologist posting. “We refer all our male patients to the urologist. We may get an additional posting if the government decides that it is required,” said Dr Manonmani. Most hospitals also have geneticists and infertility specialists. “Otherwise, we have 20 gynaecologist cum obstetricians, including five heads and 15 assistant professors,” said the college dean, Dr B Ashokan. “We have the space and staff. We only need the equipment,” he added.

Infertility specialists say specialized training in reproductive medicine is as critical as the equipment for the treatment to be successful. “There are courses for gynaecologists and obstetrics to take ranging from two weeks to even two years, but a proper training is required for the doctors to know the exact dosage of medication or injections to administer and stimulation protocols. There are a lot of nitty-gritty in infertility treatment, especially IVF, with regard to monitoring the hormones and monitoring growth off the egg,” said senior consultant in Gynaecology Laparoscopy and infertility at Rao Hospital, Dr Damodar Rao.

Dr C V Kannagi Uthraraj, infertility specialist at Kovai Medical Center and Hospital, said, “Assisted reproductive technology requires a mix of skill and knowledge. The clinician might get knowledge from books, but skill requires at least a year’s training, 20 cases assisting a specialist and another 20 cases overlooked by a senior. An extremely skilled embryologist is also crucial for the success of a treatment. A good laboratory and quality control is also important,”.

Infertility doctors welcomed the move with infertility being on the rise across sections of the society. While one in 20 women suffered from infertility two decades back, it is now one in eight women. “Many women do come for infertility treatment because they can’t afford it. Infertility is as important as any other health problem, because it causes a lot of mental trauma for couples who do not have a child. Government hospitals should offer it,” said Kannaki Uthraraj, infertility specialist at KMCH. “Of the 200 to 250 new patients we get with infertility issues, 50% are from the lower economic sections of society,” Dr Damodar Rao said.

(*Name changed)