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Sunday, March 7, 2021

Pregnant pause

Reading Time: 4 minutesModern lives are so hectic. Everything seems to revolve around beating the clock, including the biological one, as more women now choose the option of preserving their fertility by egg freezing.
Indian Link spoke to IVF and fertility specialist Dr Chandrika Parmar, one of the first women from an Indian background to practise as reproductive and endocrine specialist in Victoria, to shed some light on fertility preservation or egg freezing, a complex and ethically controversial treatment.
Chandrika Parmar.Indian Link
Also under discussion was the recently confirmed Yes vote for same-sex marriage and Australian LGBTQI’s right to have the same opportunities for love, commitment and happiness as everyone else.
Chandrika currently has her consulting rooms at 380 Victoria Parade in East Melbourne. Encompassing a range of strategies and offering a wide spectrum of treatments, Chandrika helps people to start a family.
On her work
“Giving my patients the news of a successful outcome, seeing the joy on their face when they leave my practice pregnant and reading the birth notification cards with the newborn baby pictures are the best part of my profession,” she says.
As a fertility consultant with Melbourne IVF, Chandrika also holds a public appointment at The Women’s Hospital as reproductive and endocrine specialist. She specialises in infertility issues including recurrent miscarriage, egg freezing, donor egg and sperm, surrogacy, fertility surgery and in-vitro fertilisation (IVM).
Statistically, 1 in 6 couples needs fertility treatment. Not every woman has an unimpeded path to pregnancy. However, advances in medical science and assisted reproductive procedures have helped many realise their dreams of parenthood. This includes same sex couples.
The marriage equality vote may be recent but LGBTQI community have been parenting in Australia for many years. According to the ABS, in 2016, there are around 48,000 gay couples with children – about 1 in 10 gay men and one-third of gay women.
“The role of science in our society is to improve the quality of life of all humans and to help people who are committed to having children together – regardless of their gender,” says Chandrika.
On gay parenting
Chandrika, who is a strong Yes supporter, sees many patients from the LGBTQI communities. “There is a really good and safe donor programme on offer and same-sex couples come for donor sperm or sometimes they bring their own donors. In the last five years, they also have the option of surrogacy along with other assisted reproduction processes,” she says.
One of the reasons for opposing same sex marriage is a fear of breakdown in social fabric, and a loss of the emotional safety offered by tradition. Some opponents claim that children need a mother and a father to have role models. Some may use the sexual orientation of the parent to deny custody, adoption, visitation and foster care. Chandrika, however, disagrees.
“No study has conclusively found that children of gay couples are disadvantaged due to their parent’s sexual orientation,” says Chandrika with conviction, adding that the assisted reproduction process is not dependent on people’s commitment or their marriage status.
“There are currently people going through this treatment, whether or not they are in a committed relationship. There are many single women wanting to raise a child,” she adds.
“There will always be a divide between what people think is a conventional, traditional family, but if two women are raising a child, there’s two mothers to love and there is nothing wrong with that,” she points out.
She also thinks that the LGBTQI have a wider sense of community. They look out for each other and it’s often not just the sperm donor but the whole family that gets involved in the process.
On egg freezing
Chandrika is equally articulate on the topic of technological advances that allow the storage of a woman’s unfertilised eggs to allow her to conceive at a later date.
Demanding careers, inflexibility of academic calendars and absence of a suitable partner are some of the reasons women may wish to delay family building and explore fertility preservation.
If a woman wants a family in future but is unable to start one in her most fertile years, freezing her eggs when she is younger may allow her the possibility of having a biological child in future. The eggs are frozen unfertilised and can be thawed at a later date and fertilised with sperm, creating embryos that can be implanted in her uterus.
The quality of eggs tends to start declining for women as they age beyond 32; even more so in their 40s. This may mean that some women are unable to get pregnant as they get older. Or, if they do get pregnant, they are at an increased risk of miscarriage and having a baby with chromosomal defects like Down syndrome.
“Essentially, by using this option, women are securing themselves for some situation where things may go wrong. It’s like having insurance,” explains Chandrika. In 2014, Facebook and Apple offered to financially back female employees for elective egg freezing as the process comes with a hefty price tag.
Egg freezing does not guarantee a pregnancy, but storing 20-30 eggs before a woman turns 35 may give a good chance at a pregnancy. It’s also important to consider general health and other medical issues when embarking on freezing eggs or delaying conception.
“The ability to freeze eggs doesn’t mean one should postpone having children just because it’s possible. Although egg-freezing techniques are improving and pregnancy rates with thawed eggs are comparable to fresh eggs, there is still ongoing work and research needed in this field,” Chandrika says.
According to her, the awareness of this procedure is higher in Westerners in comparison to Indians. While some career-oriented young Indians and women with marriage breakdowns are utilising this process, social stigma remains attached to the new-age fertilisation process. The knowledge within our community is improving, albeit slowly.
(With inputs from Dr Chandrika Parmar’s article on egg freezing published by Bupa)
All about egg freezing
How it works: A woman’s ovaries are hormonally stimulated for 10-14 days, which stimulates a group of eggs to mature. These are then extracted using a 15-minute surgical procedure. An average of 10-12 eggs are collected from each round. Eggs are then frozen with a special technique called vitrification. More than one cycle can be required to retrieve enough eggs for future use.
What it costs: Each round can cost up to $9,000 or $10,000. Since it is an elective procedure, it is not covered under Medicare.
What’s the success rate: 80-90% of the eggs might survive being thawed, about 50-70% of the eggs may fertilise and create embryos and about 79-80% of the embryos may develop into good quality embryos. From the good quality embryos, a single embryo may have a 25-35% chance of developing into a pregnancy.

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Preeti Jabbal
Preeti Jabbal
Preeti is the Melbourne Coordinator of Indian Link.

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