Tuesday, October 20, 2015

Why the ART bill is bad for IVF doctors - and even worse for patients

However, a big problem with this ART bill is that it's not been crafted very well. Perhaps part of the reason is that it's taken over ten years to be actually formulated. IVF technology has progressed dramatically during this time, as a result of which some of its recommendations are now obsolete. They can actually cause harm, so that a bill which is actually meant to protect and help infertile couples, may end up hurting them.



  1. IVF industry in India is profit-driven, non-transparent and unregulated. It is high time that some form of regulation is established and the industry is made more transparent. Although regulations might curtail the autonomy of the doctor, and patients' reproductive autonomy to certain extent, it also protects the one's without much clout in the industry - ignorant patients, egg donors, surrogates etc. Regulations will also help reduce the unethical behavior by ruthless, money mongering IVF professionals ( they do exist ! ) to a great extent.

    Is it that difficult to establish egg collection centers nearby egg banks ? Is it mandatory that only IVF doctors do egg collection, any doctor can be trained to do egg collection ! Establishing egg collection centers and egg banks separately will create opportunity for many others to participate in the multi-billion-dollar industry which is now solely ruled by IVF doctors. This itself increases transparency and reduces unethical behavior.

    Although creating ART banks might increase bureaucracy and paperwork for the doctors, it also ensures transparency, which is good for everyone involved.

    Egg banks are actually beneficial for the doctors as they have one less work to do. There is no hassle of going behind egg donors ! Patients need not wait long to find a suitable donor, as the egg bank will be having a huge collection of eggs from different donors , ready to be purchased and used. Patients can also be sure that they pay the same price for the eggs irrespective of the clinic they go.
    The most important benefit is, it will make sure that donors are not repeatedly used and exploited. They can also be sure that they get a proper remuneration.

    I think, IVF doctors shouldn't object to the attempts made by the government to regulate IVF industry. If they find that a particular rule curtails their autonomy or patients' reproductive autonomy unfairly, they must give suggestions to make the rules better. If they continue to stand in the way of regulating IVF industry, which is the need of the hour, it further adds strength to the claims of unethical behavior by IVF doctors !

  2. You write - - Is it mandatory that only IVF doctors do egg collection, any doctor can be trained to do egg collection ! This is exactly the problem when non-doctors try to regulate medical treatment. Egg collection needs specialised skills, experience and expertise. Only IVF specialists can do egg collections. It's very easy to stick a needle into a blood vessel during an egg collection - and who will then take the responsibility for this ? Setting up an egg bank will mean setting up an IVF lab in the egg bank - but the rules prohibit this !

    Regulation may look great on paper - it always does. However, it's only when it's actually implemented in real life that patients will understand the harm the unintended consequences of these well-meaning rules cause.

    IVF specialists have nothing against regulations. It's just poorly drafted regulations which we worry about, because we can see the harm these will cause in the future.

    By introducing egg banks., you will just increase the cost which patients have to pay. And you say IVF specialists are unethical and ruthless. So what makes you think egg bank owners will be any different ?

    1. I still do not see a point in your argument. Are IVF doctors born with an inborn skill to do egg collection ? Any technical expertise can be mastered with practice. Gynecologists can be easily trained to do egg collection. Because you are an IVF doctor, you see everything in your perspective. This is the reason why non-doctors, non-IVF doctors, must formulate rules !

      Regulation doesn't guarantee 100 % ethical behavior ; any regulation does lead to unintended consequences - pleasant or unpleasant . Does the presence of unintended harmful consequences means we should never act ? You blog about IVF doctors' misdoings, but, when the government is trying to do something to rectify the situation, you people object to it. It would have been nicer if you have written about how to improve the rules and regulations. Why can't IVF doctors join hands and demand a place in the regulatory committee so that unintended harmful consequences of the regulation could be foreseen and minimized ? I bet IVF doctors will never join hands together, because, it is not a profession but a business ; it is not a service-driven industry but profit-driven. IVF providers will be the most apt word for majority of IVF doctors !

      I am not saying egg bank owners will be different. My thought is, IVF industry shouldn't be ruled single handedly ! Split it into parts - egg collection centers, egg banks, surrogate recruitment agencies, once the surrogate gets pregnant caring for her and the prospective baby must be done by a different set of people. In this way the money generated in the IVF industry is distributed evenly, and the biggest benefit is, when there are more players in the scene, more chaos it will create. Chaos naturally leads to change, better regulations and better rules. Transparency and ethical behavior increases as everyone in the industry is watching each others actions. It increases the probability of someone blowing the whistle when something goes wrong and as a result the industry becomes a better place ! If I have the power to do so, I will :)

    2. I think you are evading the central point. If egg banks need to do egg collections, they need an IVF lab to do so. IVF labs need to be registered under the ART Bill, which also says that there can be no connection between the egg bank and the IVF center. How do you resolve this issue ?

      IVF doctors are happy to provide inputs, but govt bodies do not usually factor these in when crafting their rules.

  3. I didn't understand this point, but, ah Dr...when egg collection is done in a place where no Invitro Fertilization is not done, call it as egg collection lab, why do you call it as an IVF lab !!! The bill is great, otherwise every IVF clinic will own an egg collection center and an egg bank !

    Who said govt bodies don't give you people a chance ? Actually, IVF doctors don't have time for all this ;)

  4. Yes, IVF doctors don't have time to waste in Govt offices because they are busy doing IVF to help infertile couples to have a baby


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