As a child wanted to be a doctor and was very impressed by Dr Hinduja's feature in The Illustrated Weekly of India. As I joined MD in Gynecology was fascinated by this subject and hence my specialisation.
What motivates you in this field?
The happiness, good wishes of all successful couples..and the frustrations
of all those who have not made it. Yet..
What is good patient care?
Understanding the pain, clear communication, a good IVF lab and excellent
How do you address a patients emotional needs?
A patient initial consultation where all issues are addressed. The team
then takes over to comfort them through the journey. I am always there as I
do all procedures myself including their scans.
Who is an ideal patient? And an ideal infertility doctor?
An ideal patient has made up her mind. She understands the process and
trusts the doctor. She is hoping for the best, but is prepared for the
An ideal infertility doctor is well trained, has an excellent staff, has
good communication skills and is humane.
Can you describe the most challenging case you have handled so far?
One case involved an American lady with repeated IVF failures elsewhere. We
had tried twice and I was not willing to try anymore as her egg quality was
not good nor the endometrium. She still wanted to try and went ahead with 3
more cycles elsewhere. After being unsuccesful, she came back with her
sister to try a donor egg IVF cycle. I suggested we go ahead with surrogacy.
She was still keen to conceive in her own womb, understandably. That failed.
By now, she had come to terms with her condition. She was open to surrogacy.
She did 2 cycle with me. Both were successful and now she is a happy mother
of a boy and and girl. In this long tiresome journey I must also give credit
to her husband who stood by her always.
Another involved a middle class couple from New Delhi. They had undergone
two IVF cycles elsewhere. I did an ultrasound and found what is called a
hydrosalpinx, which is water in the fallopian tubes. This can be harmful to
the growing embryos in the uterus and reduces success by half. I went ahead
sand did a laparoscopic procedure where we disconnected this damaged tube
with the uterus. We tried an IVF cycle which failed. Fortunately, we had
frozen enough embryos. We thawed the embryos and transferred three. She
became pregnant. Today the couple are proud parents of a beautiful daughter.
The third which I want to highlight was not a technology driven case, but I
remember the relief on the couples face when I told them they did not need
any expensive treatment. This couple were unable to consummate their
marriage for the past 5 years. They had been to all kinds os specialists and
tried everything. They were now desperate to have a child. They were told
this could never happen till they consummate or IVF was the only option.
They were mortified of IVF. I assured them that this was not necesssary and
explained a simple technique called Artificial Insemination which they could
practise at home. The couple were immensely relieved. They came back 4
months later with beaming faces and a positive pregnacy test.
How would you explain IVF to a layman? And what all is involved in it?
IVF means In Vitro Fertilization, meaning fertilization outside the body as
opposed to In Vivo Fertilization which is fertilization inside the body,
which happens normally. In this a woman is given hormonal injections for 10
days from the second day to create many mature eggs as opposed to a single
egg in a menstrual cycle. These eggs are collected with the help of a
needle. There is no pain and it is a day care procedure. The sperms are also
collected the same day and fertilization is done in the lab. The fertilized
eggs becomes embryos which are the initial stage of the baby. This is
inserted 2-3 days after fertilization. There is then a 2 week wait when we
come to know if the embryos have implanted or not and if the process has
Is IVF hard to go through?
Emotionally, yes. Since most patients think, this is the last option and if
this fails, it is the end of their hope. Also, for many it is financially
taxing (around Rs 1.5 lakhs/cycle , all inclusive). The pain of injections
post transfer is also high. However, if one is fully prepared for the
process, then for many, IVF is a breeze. I have had many patients saying
that they did not know IVF was so simple and easy, since they read many
misguiding stories on the internet.