CREATE / KILL a baby

CREATING  A  BABY  and  KILLING  A  BABY

Dr. T. Rama Prasad

CREATING  A  BABY

            In vitro fertilization (IVF) or 'Test-tube baby formation' is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.  There can never ever be a greater gift than giving a child to a childless couple.  The IVF specialist is revered more than god as she/he gives what god didn't.

A day may come when one may place an order for a baby.  There is already a ‘rent a womb’ system of surrogate mothers and ‘test-tube’ babies.  Through ‘genetic screening’ and ‘ next-generation sequencing’ one may even select genetic characters.  A baby boy was born on December 9, 2017 in China four years after the death of his parents in a car crash !   The couple's 'fertilised embryos' were stored during their infertility treatment.  The parents of the dead couple painfully navigated unchartered ethical and legal territory to get possession of the embryos ... then transported them to Laos as surrogacy has been illegal in China ... then got two embryos implanted in a Laos native woman ... one embryo was successful ... then took the pregnant woman to China for delivery.  What to tell the boy about his entry on to this planet when he grows up ?    Crazy creations ... acceptable ?  And, an 80-year-old man and his 74-year-old wife got twins, two baby girls, on 05.09.2019 through in-vitro fertilisation (IVF) in Andhra Pradesh ... who will look after these girls until they settle in life ?  Crazy creation ... acceptable ?

On July 25, 1978,  about half-a-century ago, Patrick Steptoe and Robert Edwards "created" Louise Brown, the world's first TEST-TUBE (IVF) BABY in UK.  Louise Brown’s birth is one of the biggest landmarks in the field of infertility treatment.  Since then, more than eight million children have been born through various “Assisted Reproductive Techniques” including IVF, and several other advanced techniques have evolved since then. To mark the greatest innovation in the field of reproductive medicine this day, 25th July is celebrated as the World IVF day every year. 

Professor Robert Edwards - shown here on December 7, 2008 with Louise Brown, who was the world's first test tube baby - was awarded the 2010 Nobel Prize in Medicine. (AP Photo/Chris Radburn/PA Wire)AP PHOTO/CHRIS RADBURN/PA WIRE)

The INDIAN STORY

Subhash  Mukhopadhyay "created"  'Durga',  the world's second IVF baby in India, just 67 days after the first one was born. He achieved this amazing success with little support (even appalling antagonism) and meagre facilities available at that point of time in India. Instead of appreciating, the powers that be in the West Bengal government at that time harassed him, discouraged him, disapproved his work and prevented him to go abroad to present his achievements to the international scientific community. Hence his success was not officially recognised. Dejected, he committed suicide in 1981.  How sad ?  His life and death was the subject of the Hindi movie 'Ek Doctor Ki Maut' (Death of a Doctor).

ADVANCEMENTS  LATEST  IN  THE  FIELD

Two remarkable events occurred in the year 2013 in the field of IVF. One is about Mrs. Ruth Carter (42 yrs) who has become the first in the world to give birth to a baby in UK in June 2013 availing a technique called EEVA (Early Embryo Viability Assessment) which takes thousands of photographs, using time-lapse technology, at one-minute intervals of the developing embryo outside the human body to select the most viable of the lot to improve IVF (In Vitro Fertilisation -- Test-tube 'mating' of egg & sperm outside the human body).

The second one is about Mrs. Marybeth Scheidts (36 yrs) who has become the world's first to have an IVF baby born, using an embryo selection procedure that can read every letter of the human genome (genetic screening), at Main Line Fertility, a clinic in Pennsylvania, US, on May 18, 2013. The facility of 'next-generation sequencing' (NGS) reading of the whole genomes makes one to judge the chances of the child developing certain diseases, such as cancer, heart disease, Alzheimer's disease or Down's syndrome, and possibly avoid such diseases through right selection of the embryo.

IVG babies:  Researchers at George Washington University (US) are examining the possibility of using “in vitro gametogenesis” (IVG) for human reproduction (2015).  Gamets are derived from pluripotent stem cells or embryonic stem cells. IVG differs from IVF in facilitating people (even same-sex couples, postmenopausal women and premenarche girls) to have biologically related children without using gamete donors.  This may sound absurd from the sociological, ethical and legal contexts.  

 LATEST  IN  THE  FIELD

                Different gamete or embryo manipulations are performed to assess the integrity of embryos before transfer.  Preimplantation genetic screening involves sampling a single cell or a few cells from a 'day three embryo' or a 'day five blastocyst'.  Another available way of testing is to screen individuals for inheritable genetic conditions before using them as gamete donors or to perfect the mode of inheritance.  'Inherited Disease Panel (IDP' is a simple blood test which screens 328 genes to detect over 700 conditions.  

YAGNA  to  EEVA  to  NGS

            Long ago, when I first heard about test-tube babies, I thought that babies were grown in test tubes ! So ignorant I was ! For a minute, let us go back to our mythology and scriptures. Even in the days of 'Ramayana', this problem of infertility was present, though sedentary life, late marriages, smoking, junk food, aspartame in aerated beverages, gizmos, laptops, erratic working hours and bad lifestyle (which are incriminated as some of the reasons for infertility in modern times) were not there in that 'yuga'. King Dasarath who had 3 wives was childless. Through  'Putra Kameshti Yagna', advised by sage Vashist, the 3 wives gave birth to Lord Ram,  Lakshman,  Bharath and Satrugan. 

FERTILITY  CENTRES  (IVF)  IN  TAMIL NADU

            Around 150 private fertility centres in 26 districts in Tamil Nadu are operating as of 2023 while there are none in the public sector.  An activist, Veronica Mary, demanded the government to open fertility centres across the State.  The State government announced in June 2023 that it will open two centres in Chennai and Madurai in September 2023  (The Hindu, July 2, 2023).  The activist's demand is based on the huge expenditure involved in IVF.  Perhaps, based on the huge transactions, The Central Board of Direct Taxes (CBDT) decided to keep close tabs on transactions done at IVF clinics in India (Times Business, TOI, July 6, 2023).

RELIGIOUS  PERSPECTIVES

           We have come a long way -- from 'YAGNA' to EEVA to NGS !!
Playing GOD ?   “Don’t play God,” says the Roman Catholic Church which opposes all kinds of in vitro fertilisation.  The nation of Costa Rica has a complete ban on all IVF technology.  A few countries have imposed certain restrictions, but the procedures are generally accepted all over the globe.

            In a textbook of assisted reproductive techniques, Dr. Raphael Ron-El and Dr. Botros Rizk mentioned that ‘Christianity’ claims that an embryo and fetus are considered as persons.  As such, the debate hovers around the definition of “a human being.”  Is the Zygote or embryo a human being ?  In Hinduism, the soul which is eternal reaches perfect existence called “Moksha / Mokasa.”  In Bhuddhism, the long string of reincarnation and final purification of the soul is called “Nirvana.” 

           Religion is an outcome of beliefs and heritage, and hence is not debatable.  The authors of the text cited above, after a lengthy endless ‘debate’, concluded that “the strength of technology of extracorporeal procreation, with all the problematic questions that have been raised and the strong natural desire of having offspring demand all involved parts to continue enabling the couples who need our help to give them our support and aid.”

'American FATHER OF IVF' !!!

WEIRD,  WHACKY,  BIZARRE  and  CRAZY  --  IVF  is also dragged into the American Presidential Elections of 2024  !!!

SENSElESS  INTERVENTIONS

          See the news and the photo above.  It has made a warm and fuzzy story for the readers to savour.  It is clearly an irresponsible and  selfish play with life -- the lives of the two just-born girls who are likely to be parentless even before joining elementary / high school,  and the lives of the aged (80 and 74) parents who are unlikely to be around to see their just-born daughters playing games (with India's average life expectancy at 70).  What care these two senior citizens in the photo can give to the kids and for how long ?  Would the hospital take care of them later ?  This is a sad commentary on our society which is fixated on having biological children ... unfortunately, infertility is a strong stigma in India and some IVF specialists cash in on this.  Some specialists take pride in being successful in 'test-tube' baby procedures (IVF) in the very elderly -- negative achievements which make sensational news of senseless advancements.  

        Though it may not be illegal at that point of time, various IVF specialists  and doctors across the country condemned the doctor who did the procedure on this elderly woman, and some of them wanted the insensitive doctor to be put behind the bars (TNIE 07.09.2019). Jaideep Malhotra, president of the Indian society of Assisted Reproduction said that it is immoral and unethical on the part of the hospital to have put the life of such an old woman (Mangayamma) at risk and that this is yet another example of how cheap human life is in India.  

           The sperm of the  aged man may have DNA abnormalities and hence the children may suffer from various problems in future, and the preterm twins of such an elderly woman may suffer from physical and mental deficiencies,  in addition to the psychological trauma of losing parents (who look like grandparents) at an early age.  And, the pumping in of hormones into the aged woman may increase the risk of breast and uterine cancer.  

            This incident made many make a demand, at that time,  to expedite enacting of the then long pending ART bill which proposed to bar men above the age of 50 and women above the age of 45 to have test-tube babies (IVF).   The 'powerful' ART (IVF) body seems to be blamed for not taking the bill prepared in 2008, 2010 and 2014, based on ICMR's guidelines, to the Parliament.  This case kicked up a storm of outrage at the Guntur hospital for lack of common sense and sensitivity.  Jashodhara Dasgupta, a specialist on reproductive rights, said that there should be a stop to exploit the infertility market.   Nandita Palshetkar, a Mumbai-based infertility expert, fumed that this event is simply horrible and that no medical institution should offer what the clinic in Guntur did.

   Australian Kim Tucci gave birth to 4  daughters & a son in January 2016 – conceived naturally  --  one in 55 million is the chance for quintuplets.

Test-tube puppies  ...  to know a bit about these puppies, read under the title "TEST-TUBE  PUPPIES on this blog.

KILLING  A  BABY

            Even as babies are 'created',  'babies' are being killed before birth !  And, ironically,  both the 'events' are executed by doctors.  Paradoxical.

          Ultrasound scans come in handy to detect the sex of the unborn child and terminate the 'unwanted' female, despite the legislation against it (PCPNDT Act). Female foeticide, female infanticide, illegal identification of sex of the unborn children and illegal abortions have become common in our society.  Legislation doesn’t work. The malpractices very rarely come to the surface for obvious reasons, just as in the ‘dowry’ practice.  One of such  rare and sensational episodes came to light recently (2017).  A renowned Agra gynaecologist who was the former president of the Indian Medical Association was caught after being entrapped through decoy patients by Rajasthan PCPNDT team (2017).  The Court sent her to jail along with five others by rejecting bail application (docoplexus, July 15, 2017).

IMPORT  BRIDES

          On Apr. 30, 2013,  the government of India revealed that the child sex ratio is at its lowest since Independence (in the age group of 0-6 years it came down to 919 females per 1000 males). It means that, even if all the women get married, 976 lakhs of men cannot get a wife in India at any point of time.  Statistics show that there are only 767 girls to 1,000 boys in some districts of Uttarkhand.   In certain parts of the country, which have been described as the “Bermuda triangle”, the ratio is a shocking 774:1,000 !  At this rate, in future,  India may also have to “import” brides as is China doing from Vietnam, Laos or North Korea.  Due to the ‘One Child’ policy in China there has been a manpower shortage which prompted the government to allow some eligible couples to have a second child.  Paradoxically, in Beijing, only 6.7 per cent of the couples applied for permission for a second child. When a norm is set in, it is likely to persist. In India, the norm is set in to prefer male progeny.  And it is likely to persist despite the gloomy forecast.

COMICAL

          What takes the cake for an ingenious discovery is about the gender preference of Indians for their progeny.  Some facts and figures projected by our governments seem nearly comical and flawed – look at this news (TNIE, Oct.11, 2011):  “According to the latest report of the Central Statistics Office (CSO) on Gender Issues, 75 % of Indian women prefer to have girl babies.”  Then, -- you guessed right -- why are we crying hoarse against female foeticide, female infanticide, illegal identification of sex of the unborn children and illegal abortions ? Hypocrisy of  bureaucracy ! One of the victims is baby Afreen, a three-month baby girl, who died on April 10, 2012  due to battering and biting by her father who wanted a ‘boy and not a girl’.  McGlobalkinsey Report says that economy will not gain by reducing the number of women.

SATYAMEV  JAYATE

          Following up his focus on female foeticide in the first episode of his television debut Satyamev Jayate, film star Aamir Khan (who is awarded by America Abroad Media for enlightening the public through media) met Rajasthan Chief Minister seeking speedy trial of those charged under the PCPNDT Act, following a sting operation in Rajasthan by a television channel a few years ago, collecting evidence against the doctors who did the illegal abortions (The Hindu, May 10, 2012).  And,  as many as 16 foetuses of the age of 2 to 3 months were found dumped on the bank of the Hiranyakeshi river on January 26, 2013 (ironically enough, it happened to be the Republic Day !) at Sankeshwar, in Belgaum district which has the worst child sex ratio in Karnataka State, with only 931 girls per 1,000 boys (The Hindu, Jan. 28, 2013).     Doctors who abet these crimes should do some introspection and some soul-searching and reform themselves, as it is extremely difficult to prove their culpability. 

Union Health Ministry has agreed to make certain changes in the draconian PC-PNDT Act. This decision has angered many doctors and women’s rights activists who fear that the proposed amendments will weaken this act and further aggravate the imbalanced sex ratio in the country. The PC-PNDT Act 1994, which was enacted with the aim to curb female feticide, has failed to improve the sex ratio in the country despite being in existence for over 20 years. Even a smallest error in compliance of the Act, either in sex determination or non-maintenance of records, brings heavy penalty on the errant. Thus, implementation of this draconian Act has major negative consequences. Therefore, IMA has been demanding major revisions in the PC-PNDT Act since 2015, stating that “In its current form, the implementation of the Pre-Conception, Pre-Natal Diagnostic Technique (PCPNDT) Act has deprived the community of life-saving and essential ultrasonography which has now become an extension of clinical practice for all specialties globally, being a well-known non-invasive, cost-effective and accurate diagnostic tool.” (The Hindu, October 25 2015) In this regard, IMA had 2 key demands: There will be “graded punishments” in case of violations of the act Non-obstetric ultrasound centers will not be required to be registered anywhere. The health ministry has agreed to these changes and the changes are likely to come within next 45 days (May 2018). A women’s right activist who was instrumental in the framing of the PC-PNDT act said that “Specifically, the strong deterrent sections will be amended by bringing in graded punishments which will lead to conversion of criminal offences into technical deficiencies (clerical errors).” (New Indian Express 10 April 2018) Source: New Indian Express

         

The statistics and the happenings expose the continuing discrimination against the girl child in our society. The phenomenon of “disappearing” female little ones in India is due to the despicable attitudes and patriarchal prejudices that guarantee that girls will not be born and that if they are, their health will not be taken care of adequately.  In the election season where rhetoric is the king, this subject of “killing” the female is not even a blip on the horizon though eloquent and loquacious voices are heard on “empowerment” of women !  Political hypocrisy ! 

NO  SOLUTION

            Political will is crucial.  A most unexpected “solution” for the problem came from the mouth of the Union Minister for Women and Child Development, Maneka Gandhi at a conference in Jaipur (January, 2016).  It is this:  1.  Establish the sex of the foetus when pregnancy is detected.  2. Tell the mother about it and and register the fact in public records.  3. Ensure that deliveries happen only in institutions and not at home.  4.  Tracking sex-determined foetuses and imposing institutional deliveries would ensure that female babies are not aborted, or killed at birth.  “While this idea might seem persuasive, like many technological fixes it betrays a worrying lack of awareness of social realities”  (http://www.thehindu.com/opinion/editorial/editorial-on-maneka-gandhis-statement-on-foetuses/article8189286.ece ).  Endless debate is going on on the effectiveness and practicability of this solution to the problem. 

A bus in Coimbatore city with an unusual and very meaningful message

                                                                                        

Girl child is the dearest 'commodity' !  

Don't senselessly crave for a male child and don't 'kill' unborn girls.

                                              Loving they are

                                                  Care for you more

                                                  Daughters they are.

                                                  Pregnant you are

                                                  Promote your gender

                                                  Pray for a girl babe.

                                                              --  T. Rama Prasad

                                                                                                                                                        

THIS  IS  AN  ABRIDGED  TEXT  OF  MY 'SCRIBBLING'.      FULL  TEXT  WILL  BE  POSTED  LATER.         --  T. Rama Prasad