Saturday, June 19, 2010

IVF treatment: 66-year-old childless woman gives birth to triplets •As world’s oldest mum says she is dying from IVF complications

A 66-year-old Indian woman has become the oldest person in the world to give birth to triplets after IVF treatment at a controversial centre.
Childless Bhateri Devi gave birth to two boys and a girl –– who are now being treated in intensive care after being born dangerously underweight.


Mrs Devi received IVF treatment at the National Fertility Centre in Haryana –- where the world’s oldest mum, Rajo Devi Lohan, was also treated.
However, the doctors said the triplets, weighing 2 pounds 6 ounces, 2 lbs 4 ounces and 1pound 7 ounces, were being monitored in the intensive care unit of the centre.
Mrs Lohan, 72, who gave birth 18 months ago aged 70, has revealed she is dying –– and hit out at the centre for not explaining the risks to women about having babies later in life.
However, officials at the centre proudly boasted of their latest achievement.
Dr Anurag Bishnoi, who supervised Mrs Devi’s treatment, said: “According to the birth certificate issued by a government hospital in Rohtak district, Bhateri Devi was born on May 21, 1944 in Madina village of Rohtak.
“This birth is authentic and therefore she has become the oldest mother in the world to give birth to triplets so far.
“Bhateri Devi was coming to us for the last months for the treatment. She has become a mother for the first time and conceived only in our third attempt through IVF technique.
“For the first two attempts, only two embryos were transferred in each cycle.
“But in third attempt three embryos were transferred in her uterus, resulting in the birth of three children by caesarean.’
Mrs Devi’s husband of 44 years, Deva Singh, 64, said he was ecstatic at becoming a father for the first time.
“Bhateri has fulfilled my dream of having a child and gave my family an heir.” he said.
‘She was my first wife and after she failed to conceive a child, I married twice but again I did not have any child from my other wives also.
“I am very happy and I will provide all the best facilities to my children in the coming years.”

In November 2008, 70-year-old Mrs Lohan made headlines after she gave birth to a girl through IVF technique at the same centre.
She and her husband, Balla, 73, are uneducated farmers who said they did not understand the risk of having a baby at such an old age

Is IVF Good Value For Money?

Children conceived by Medically Assisted Reproduction (MAR) have fiscal implications for government both in terms of future government spending and tax revenue. Based on public funding to conceive a MAR child - after factoring in education, future health and pension costs, and future tax contributions of this child - the discounted net tax revenue (the difference between future government spending and tax revenue) of a child born in 2005 is roughly 127,000 euros in today's value.

Considering an average treatment cost of approximately 15,000 euros to conceive an IVF-child, this represents an 8-fold return on investment (ROI) for governments [1]. While the costs of MAR treatment represent a substantial proportion of a patient's annual disposable income, MAR typically represents less than 0.25% of total national healthcare expenditure. By comparison, obesity accounts for 10% and 2-4% of total health care spending in the US and Europe respectively.

MAR treatments elicit significant medical, reproductive and economic influence in developed countries with 3.5 million children estimated to have been born worldwide since 1978. These children make up a substantial proportion of national births with up to 4.1% in Denmark and 3.3% in Belgium. In the US, Europe, and Oceania over 600,000 treatment cycles resulted in 120,000 children being born in 2005. The European Society of Human Reproduction and Embryology (ESHRE) Task Force on 'Reproduction and Society' reviewed the economics of MAR to evaluate the benefits of funding of MAR for society and to inform policy makers on effective, safe and equitable financing of MAR. Dr. Mark Connolly and colleagues who published this review paper in the journal Human Reproduction Update based their findings on key epidemiological and economic studies. Affordability of IVF is one of the main drivers of treatment utilisation, choice of treatment, and embryo transfer practices which ultimately influence the multiple birth rate and infant outcomes.

Although the poorer clinical outcomes are well known, the indirect costs and hence the economic burden associated with MAR multiple birth children - which may extend well beyond the perinatal period - are less appreciated. Lack of affordable treatment may force patients and clinicians to opt for cheaper fertility treatments such as stimulated intrauterine insemination and ovulation stimulation which have less controllable means of minimising multiple births. If treatment is appropriately funded, there is less of a financial incentive to achieve pregnancy in a limited number of cycles. Additionally, restricted treatment and limited financial access coerces some patients to seek cross border reproductive treatment in countries where cheaper or less restrictive treatments are offered. The ESHRE Task Force on 'Cross Border Reproductive Care' showed in a recent survey that, of those patients that sought cross border reproductive care, only 13% received partial reimbursement and 4% total reimbursement in their own country. Different standards of care and less responsible embryo transfer practices are amongst the risks patients' face when going abroad
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