Amid different developments in this sphere, ART is another revolution that ensures safe motherhood to the ones with difficulty conceiving a baby
Representational image. Cassidy Rowell/Unsplash
The widespread impact of technology on the contemporary world is all-pervasive. There are rarely any aspects of human life that have remained unimpacted by the technological revolution across the globe. In this tech-enabled run, the development of the healthcare system and processes is exemplary. And amid various aspects of healthcare that are being equipped with advanced technologies and techniques, utilised for better delivery of healthcare services, maternal care under reproductive health awaits its due share.
In India, the latest Maternal Mortality Statistics estimated the MMR to be 103 per 100,000 live births. Building a continuum of care that promotes accessibility and the use of effective care during pregnancy, birth, as well as the postpartum period has become necessary to ensure that the mother and the baby are healthy. This intensive care is inevitable for bringing us closer to or achieving the Sustainable Development Goals by the UN, which aspires MMR to be not more than 70 out of 1,00,000 live births by 2030. Although India’s MMR has reduced over the years, we are still way behind the number mandated by the UN.
Amid different developments in this sphere, Assisted Reproductive Technology is another revolution that ensures safe motherhood to the ones with difficulty conceiving a baby. ART helps the couple in the identification and timely remediation of underlying conditions that might, otherwise, hamper the pregnancy and even go on to result in cases of Maternal Mortality. It ensures different pre-conception care in comparison to the natural conception by not only help in identifying the diseases that might create problems in safe pregnancy but also play an essential role to contribute in the treatment of such diseases before a woman is set on the journey of motherhood.
Under the ambit of ART, we see techniques like In vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), etc. Thus, with a chain of steps accompanied with intensive guidance and observations at every phase, ART prevents exposure to vulnerability. Women with thyroid issues, for example, may develop anaemia during pregnancy and experience a rise in blood pressure, resulting in preeclampsia. There are instances where the mothers started vomiting and getting dehydrated, resulting in stillbirth, miscarriage, or premature birth in a developing kid, putting the infant’s life in peril.
Every cycle begins with an IVF specialist’s consultation, which helps to create expectations for the procedure. Following that, the couple is subjected to a series of panel tests. This includes, among other factors, blood tests to look for polycystic ovaries, diabetes, liver damage, sexually transmitted diseases, and hormone levels like prolactin in women. Ultrasound and other image-based scans are also done. This assists in determining the reason for infertility as well as determining whether there is any medical condition that has to be treated prior to beginning the ART cycle. For example, if a woman seeking ART treatment is discovered to have uterine fibroids, they will be removed via laparoscopy or surgery; if severe diabetes that could influence pregnancy and its results are discovered, she is directed to an endocrinologist.
Once these pre-ART procedures are completed, procedural ART follows. It starts with maturing several ova or eggs inside the ovary, collecting them, fertilising with the husband’s sperm, allowing the embryo to develop for 5-6 days into a blastocyst, and implanting the embryo. Technology plays an important role. Microfluidics aids in the selection of the best sperm for fertilisation, and an electronic witnessing system assures that unrelated eggs and sperm do not combine. Artificial intelligence has also been included to automate the gamete selection procedure, removing the possibility of human error. The gametes are handled in controlled microenvironments that are identical to the human body. Pre-implantation genetic testing (PGT) examines the embryo’s genetic makeup to see whether there are any chromosome abnormalities. Such irregularities have an impact on the mother’s and child’s health, resulting in illnesses including Down syndrome, haemophilia, and thalassemia, among others, and some can even result in miscarriage.
The use of ART also eliminates the necessity for repeated embryo transfers into the uterus, which are done to boost the chances of live birth but might cause pregnancy difficulties due to the presence of several developing children. As a result, single embryo transfers, which are safer in comparison, may become the norm.
Safe Motherhood involves various pillars that are essential to ensure a healthy state of the mother during pregnancy, birth as well as the postpartum period. The pillars include family planning, antenatal care, obstetric care, postnatal care, post-abortion care and control of Sexually transmitted diseases. Governments across countries have taken various steps to ensure the same. In India, the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) and the Surakshit Matritva Aashwasan (SUMAN) are two such programmes initiated to enrich and safeguard the health of pregnant mothers and their children. On the parallel, with application of Assisted Reproductive techniques (ART) rising amongst the infertile couples, who used to seek other methods or unhealthy practices for conceiving a baby, the SDG of less than 70 MMR per 1,00,000 live births is not far at all.
The author is CEO and co-founder, Indira IVF. Views are personal.
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