SUCCESS STORY

With advancement in science and fast track lifestyle, aggressive fertility treatments practices at IVF clinics are thought to put women and babies at unjustified risk. On the other hand, milder and safer approach to IVF could provide equivalent success rates over a longer period at a lower cost, believes Dr. Asha Tushar Dixit.

Putting her theory to testimony, Dr. Dixit shares a case, "A 35-year pregnant woman entered the emergency department of Dixit Hospital, Vapi, with a complaint of agonising pain. She presented a history of laparoscopic myomectomy followed by intracytoplasmic sperm injection (ICSI) OD after 6 months. She conceived twin pregnancy in the first cycle and was 8-months pregnant when she entered the emergency department. Thorough examination and investigations were indicative of life-threatening ruptured uterus and two foetal demises. Hence, an exploratory laparotomy operation was taken up to save the life of the patient at the hospital."

After four days, the patient was discharged with a healthy post-operative course. After 2.5 months, the patient was operated for obstructed umbilical hernia at Dixit Hospital with a healthy post-operative course. However, the patient was advised to avoid conception. After 10 months, the patient entered Dixit Hospital with 16 weeks of pregnancy with IVF procedure done somewhere else. The doctor recalled, "She was a case of OD with past complications. With a complex past history and anticipated uterine rupture, the patient was advised hospitalisation for observation and rest when she saw us at 27 weeks conception. Steroids and MgSO4 were injected for foetal lung support and neuroprotection respectively. Eventually, uterus ruptured at 28 weeks and emergency cesarean was conducted. Fortunately, both mother and child were healthy in the operative course. But, the dilemma was whether second IVF was worth the risk?" The doctor concludes that although this patient was blessed, not all could be this fortunate. She says, "Risk-benefit analysis should become mandatory before taking up an IVF. Let us evaluate, Where to stop?"