ART and Surrogacy

ASSISTED REPRODUCTIVE TECHNOLOGY (ART):

The techniques which assist the infertile couples to conceive babies by various medical means which otherwise are incapable of having it naturally.
It is a boon to infertility treatment.
There are different types of assisted reproductive techniques (ART):

• Invitro fertilization – embryo transfer (IVF).
• Intra Utrine insemination (IUI)
• Intra cytoplasmic sperm injection (ICSI)
• Frozen embryo transfer (FET)
• Gamete intra fallopian transfer (GIFT)
• Zygote intra fallopian transfer (ZIFT)
• Pro nuclear stage tubal transfer (PROST)
  
  

Among the above-mentioned types of ART Techniques, In Vitro Fertilization is the most common type and most successful techniques.
First test tube baby in the world is Louise Brown, was born on 25th July 1978 in a Manchester Hospital by IVF procedure.
Delivered through Caesarean section, Louise Brown weighed 2.6 Kgs on birth. Her birth has been recognized as the most remarkable medical breakthrough of the 20thCentury.
In 2006, Louise Brown gave birth to a baby boy who was conceived naturally. Since the birth of the first test tube baby, over 8 million babies have been born from IVF procedure.
First test tube baby in India was Kanupriya Agarwal who was born on 3rdOctober 1978. Late Dr. Subash Mukherjee was the first ever person in India and 2nd in the world to create a baby through IVF procedure.

Advantages:

• Helps to overcome infertility in both men and women.
• Pregnancy in women with blocked or damaged fallopian tubes.
• Women with cancer.
• Less chance of miscarriage.
• Women with menopause or pre mature ovarian failure.
• Selection of perfect time.
• Women with endo metriosis.
• Improve the chance of having a healthy baby.
• Women with low ovarian reserves.
• Women with poly cystic ovarian syndrome.
• Women who would be unable to bear a child.
• A useful option in single women.
• A useful option in same sex couples.
• Pre implantation genetic diagnosis.
• Pre implantation genetic screening.
• Human embryonic stem cell research.
• Egg donor.
• High success rate.

Disadvantages:

• The economic and political environment of the country.
• High risk for mother.
• Medical care equipment.
• Multiple pregnancy, or two or more embryos implantation at a time.
• Side effect from fertility drugs such as ovarian hyper stimulation syndrome.
• Ectopic pregnancy, where embryo settles outside the uterus.
• Cost.
• Low resource countries.
• Reproductive aging.
• Insurance companies

Surrogacy:

It is an arrangement in which a woman (surrogate) agrees to carry and give birth to the child on behalf of another person or couple (the intended parent/s).
A surrogate, sometimes also called a gestational career, is a woman who conceives carries and give birth to a child and gives the child to another person or couple (intended parents).

Surrogacy may be of two types:

1. ALTRUISTIC SURROGACY: It involves no monetary compensation to the surrogate mother other than the medical expenses and insurance coverage during pregnancy.
2. COMMERCIAL SURROGACY: It includes surrogacy or its related procedure undertaken for a monetary benefit or reward ( in cash or kind ) exceeding the basic medical expenses and insurance coverage.

SURROGCAY ACT 2021

• Under this act, a woman who is a widow or a divorcee between the age of 35- 40 years or a couple, defined as a legally married woman and man, can avail of surrogacy if they have a medical condition necessitating this option.
• The intended couple shall be legally married Indian man and woman, the man shall be between the ages of 26-55 years and the woman shall be between the ages 25-50 years.
• It also bans commercial surrogacy which is punishable with a jail term of 10 years and a fine of up to Rs.10 Lakhs.
• The law allows only altruistic surrogacy where no money exchange hands and where a surrogate mother is genetically related to those seeking a child.

Under Assisted Reproductive Technology Regulation Act, 2021 and Surrogacy (Regulation) Act,2021 in respect of Manipur State 6 clinics have been registered namely:

1. SHIJA FERTILITY CENTRE, KEISHAMPAT SEGA ROAD IMPHAL WEST.
2. CITY HOSPITAL AND RESEARCH CENTRE, CHINGMEIRONG, KHONANG KARAK, IMPHAL WEST, MANIPUR.
3. MAIPAKPI MATERNITY AND CHILD HOSPITAL, NORTH AOC, IMPHAL WEST, MANIPUR.
4. HOPE IVF CENTRE REMIDY HOSPITAL AND RESEARCH CENTRE, PUREILOMBA KHONANGKHONG, PALACE GATE, IMPHAL EAST MANIPUR.
5. ACME FERTILITY AND HEALTH CARE CENTRE, HEYANF HIREN LEIRAK, PALACE COMPOUND, IMPHAL EAST, MANIPUR.
6. PUBLIC CHARITABLE SUBA HOSPITAL AND ASSISTED REPRODUCTIVE CENTRE, KOMBIREI KEITHEL, RIMS SOUTH GATE, IMPHAL WEST MANIPUR