Fertility clinics go to small towns

Pratiksha Ramkumar

People going in for assisted reproduction have always flocked to big cities, but now a considerable number of people are getting treated in small towns as well. A set of statistics released by the Indian Council for Medical Research (ICMR) shows that in states like Maharashtra, Tamil Nadu and Andhra Pradesh, the technology is spreading to smaller towns even while the metros remain the big magnets of assistive reproduction technology (ART).

In Tamil Nadu, 16 of the 33 clinics are in tier III towns like Rajapalayam, Karur, Nagercoil and Ramanathapuram, according to the National Registry of ART Clinics and Banks in India. Similar is the situation in several other states. In Maharashtra, 25 of the 77 clinics are located outside Mumbai while in Andhra Pradesh 12 of the 25 clinics are outside Hyderabad, in towns like Rajahmundry, Anantapur, Guntur and Ongole in Andhra Pradesh.

"This has been happening for the past seven to eight years," says member of the draft committee for ART Bill and executive director of Nova IVI Fertility Dr Manish Banker. "Demand for infertility treatment has been increasing in small towns, so the supply chain is automatically created," he said.

Infertility specialists say that the number of clinics could be even higher in small towns. "The number of clinics enrolled in the registry is around 320. But the real number of wellequipped fertility clinics in the country is well over 700," said Dr Banker. For instance, Bangalore alone has around 44 infertility clinics, while the ICMR list says that Karnataka has just 25 clinics. "This was because many clinics have not enrolled in the registry," says head of Bangalore based Milann Fertility Centre Dr Kamini Rao.

ART experts say there is a flipside to the trend. A large number of infertility clinics that have mushroomed in smaller towns resort to performing in-vitro fertilization in batches of 10 or 15 patients, they say. "The patients are put on continuous treatment so that their IVF cycle is brought under control. Then an embryologist and fertility specialist is brought in for four days to extract the embryos, do the in-vitro fertilization and inject it back into the batch of patients," says Banker.