“ICMR was not transparent while framing guidelines”

Infertility specialists are raising hue and cry over the ICMR guidelines on ART clinics to be tabled in the parliament soon. Specialists blame the their representatives on the ICMR committee for the “not so gynecological friendly” guidelines. Dr Sadhna Desai, who took over the reins of the president of the 17,000 strong Federation of Obstetrics and Gynecologists of India (FOGSI), and one of the panelists on ICMR’s committee on guidelines on ART clinics, in an interview to Express Healthcare Management speaks her heart out on what went wrong during the framing of ICMR guidelines. Excerpts:

The gynaecologists are extremely unhappy about the ART guidelines. They even complain that though ICMR had been claiming to heed to suggestions by infertility specialists, there has been no transparency. Comment.
I know that the guidelines are unfair to gynaecologists and that there was no transparency during the framing of the same. The gynaecologists on the panel kept on voicing their unhappiness about the various requirements for ART clinics, prohibition of related egg and sperm donor, banning of related surrogate mother and accreditation of infertility specialists.

Representatives of ICMR told us from the very beginning, that they would incorporate the modifications that we suggested, but ultimately did what they had in mind.

But why would ICMR not listen to gynaecologists?
ICMR has a fixed agenda against infertility specialists. I remember one member in ICMR saying that the population of infertile couples in India is more than that of Australian population, and hence the market for infertility is very good.

So the guidelines is a way to check that practice. That is ridiculous! The guidelines are more or less like the one followed in the UK, which should not be the case considering the Indian mindset and scenario. There was unfair representation of gynaecologists on the panel. As the meeting used to take place in Delhi, at a time not more than 50 per cent of the gynaecologists were present. In the last meeting that we had, all the gynaecologists expressed dissent, but ICMR still went ahead with the guidelines, portraying it as if it was unanimously approved by all the members.

Why are you against accreditation of gynaecologists? Would not that help in checking malpractices and bring in some accountability?
Why gynaecologists should be accredited? It is stupid to accredit 17,000 gynaecologists in the country. If ICMR thinks that accreditation is going to stop malpractice, then that’s a wrong assumption. The procedure to get accreditation and re-accreditation after three years, would only breed corruption. If at all accreditation in necessary, then it is the clinics that should be accredited and not the gynaecologists. I would like to emphasise that only tertiary care infertility clinics dealing with IVF require to be accredited in a proper manner as rest of the infertility care is part and parcel of routine training of all gynaecologists.

Asking small clinics to get accredited would be detrimental to our national family planning program. It would be very difficult to motivate target couples for the terminal methods of family planning if easy accessibility is not allowed.

What are the other points that you are unhappy with?
I feel the requirements to have 13 separate rooms to run ART clinics is extremely insensible. Small space can be used for good results. If the bill is passed, then cost of IVF would go up drastically. I am also unhappy about the banning of surrogate motherhood and sperm and egg donation by relatives and friends.

How can they stop family and friends from donating, when that is the most common procedure followed by more than 95 per cent Indians? By promoting commercial donation, we are encouraging young college going girls to earn pocket money by donating eggs. Is that fair? Lets nor forget that we are Indians.

So how do you plan to take up the issue further?
FOGSI has already passed a resolution. The final meeting with ICMR would be three months from hence before the bill is tabled in the parliament. We are keeping our fingers crossed to see whether ICMR heeds to our suggestions and makes changes in the last meeting. If they are not ready to make changes, then we would represent ourselves in the parliament.

What if the parliament takes the side of ICMR and passes the bill?
Then we would obtain a stay order from the court and fight it out at the court of law.