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Kumudini Hettiarachchi meets the first all-Lankan test tube baby, her proud parents and grand parents and the team of doctors who created this miracle
She
kept us up till 3.30 a.m.," says the new mother as I peer into
the cradle at a red-faced baby, swathed in pink. Kept warm by two
small pillows with bright blue covers with balloons printed all
over them, the tiny baby girl opens her eyelids a fraction and quickly
closes them as if to shut out the world. Though a miracle
as the birth of a baby is, it's nothing special - another baby and
mother, with a concerned grandmother hovering around in a room at
Durdans Hospital. Wrong. This tiny face hasn't launched a thousand
ships like the famous Helen of Troy, but has been on the front pages
of all the newspapers and even been beamed across the world. A test
tube baby, yes, a test tube baby but "conceived", looked
after and brought into the world by caesarian section under the
care of a wholly local team. That's a first, for all the test tube
babies born in Sri Lanka earlier had a foreign touch in their making. On Tuesday,
July 2, when I visit them, all is quiet in the room where three
generations can be seen - grandmother, mother and baby. The baby
is in her cradle and the mother has more or less recovered from
the operation. "I've
longed for this moment since the day I got married eight years ago.
My dream has come true," says the mother. After being
married for a while, the fretting began when there was no sign of
a baby to complete their joy. Their relatives and friends also wondered
and worried. "We've not had a childless couple in our families,"
says the grandmother. The mental
agony increased. Living in the outstations, the couple consulted
a doctor who sent them to Colombo and then on to the Vindana Reproductive
Health Centre, where an able team took over. A battery of
tests later, both for the husband and wife, the in-vitro fertilization
(IVF) technology was explained to them. They tried it out and the
pregnancy began in September 2001. What is IVF?
It is giving a "helping hand to nature" for the ovum to
get fertilized by a sperm, outside the body of the mother, according
to the Vindana team, comprising Prof. Harsha Seneviratne, Dr. Athula
Kaluarachchi, Dr. (Mrs.) Champa Nelson and embryologist Mrs. Sumedha
Wijeratne. Explaining
the procedure, the team says, "Eggs are taken out of the mother's
body in the operating theatre, cleansed of blood and other tissue,
put in a nutritious culture medium and placed in an incubator to
develop. Sperm is also extracted from the father." "An egg
each is introduced to sperm droplets in a petri dish and once again
placed in an incubator and kept for about 18 hours to fertilize.
The fertilized egg, now a microscopic baby or embryo, with a distinct
identity with two nuclei is allowed to grow in a culture medium
which is changed frequently to give it all the nutrition it needs
and in about three days implanted in the uterus," adds Embryologist
Wijeratne, who looked after the creation of the baby girl. From then on
it takes the course of a normal pregnancy. And all this talk of
fertilization occurring in a "test tube" is simply not
true. The fusion, in fact takes place in a petri dish. "Don't
wait until the mother is very old. The moment you realize there
is a problem, go to a doctor, for the mother's age is of paramount
importance. If all tests reveal that there is simply no other way
you can have a child, then get it done before the mother grows too
old. Before the mother becomes 35 would be good," says Dr.
Nelson, adding, "The younger the better." "We are
so proud to be part of this pioneering effort where only Sri Lankan
expertise brought forth this baby," says the grandmother her
eyes moist with emotion, for this is her very first grandchild.
"Yes,
we are sad that the baby's father is unavoidably out of the country
on work at this joyous time, but there is a lot of happiness that
we are making history." They will take
the 3.15 kilo baby born at 5.31 on the morning of July 1 to the
Kelaniya Vihare to fulfil a vow they made to see a happy ending
to their childless ordeal. And through all the excitement and joy, what does this tiny trailblazer think? A big yawn is the only response I get. Don't
blame the woman
Statistics are hard to find, but male infertility can be attributed
to 30-50% of cases of childlessness among infertile couples, says
well-known Urologist Dr. Lalith Perera. "There are several reasons, but environmental pollution and chemicals in what we eat seem to be major contributory factors for male infertility. Hormones are being added to the meats we eat. In other countries it has been found that estrogen (the female hormone) is given to chickens to make them grow quickly," says Prof. Harsha Seneviratne.
Female factors
Male factors
There are also patients with unexplained infertility where all the investigations performed on the couple are normal, but who still do not conceive with routine treatments. Taking that
important decision to try out IVF A childess
couple has to accept that there is a problem and that usually is
a very difficult thing to do. Once they concede that, they need
counselling to come to terms with it. Then of course, comes the
next step of finding out the cause for being childless and accepting
that it may not be treatable, but working within it to try and overcome
the problem. In many cases, why a couple cannot conceive remains
a mystery forever. Counselling
and clearing up doubts are an essential part of this process and
with a success rate of around 30% the patients need to have a clear
picture that though they agree to the procedure, the end result
may be negative. Next comes
the need for total commitment and practically putting every other
thing in their lives on hold. The injections and the ultra-sound
scans have to be done on time, to give a few examples of the time
and effort required. Another important
area for most infertile couples would be finding the money to meet
the cost of a minimum of Rs. 300,000 for a basic procedure, but
which could be more depending on the individual woman's requirements. Once such a
treatment is decided on, comes the question of ethics. The patients'
personal feelings on such an issue and the need to maintain the
privacy and confidentiality of those trying out such a procedure.
Interwoven
into all this is the confidentiality factor not only on the part
of the doctors and others looking after the patients, but also the
patients themselves and society's attitude towards them. "A
change in society's attitude is essential. A child born through
the assisted reproductive technique (ART) should not be a curiosity.
ART should be looked at as another mode of treatment for infertility,"
urges Prof. Harsha Seneviratne, senior gynaecologist and obstetrician. What of the
government's role? "The government
needs to get involved in bringing about a rational policy on such
reproductive technologies, so that it regulates and acts as a guiding
body," stresses Prof. Seneviratne. Sri Lanka could
in fact take a leaf out of the Indian book, where there has been
state involvement in the process from the very beginning. When the
technology was being tried out in the west, the Indian government
had set apart funding for research within the country and the first
test tube baby had been born to a streetsweeper. If infertility
is on the rise, another area in which the Sri Lankan government
could get involved, in addition to setting out policy would be to
help the common man and woman find the funding in the form of loans
etc. to meet their yearning for a baby. |
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