From the President's Desk

Dear Friends,
Welcome to the Indian Society of Assisted Reproduction (ISAR). ISAR is a Professional National Organization of about 3000 Experts in the field of Assisted Reproduction in India, who are involved in the clinical practice of treating couples with fertility issues, embryologists who manage IVF Laboratories, and scientists involved in basic research.

Our goals are to assist women who need support to get pregnant and bring joy to the lives of couples. Our objectives are to update our members on the various advances which are occurring at exponential speed in our field of medicine, encourage scientific research, collaborate with like-minded international organizations, and promote ethical clinical practice. We also run professional educational courses to update the skills of budding gynecologists who are interested in the area of reproductive medicine.

We welcome you to visit our website which is in the process of being revamped so that we can offer more to our members. We have initiated the new look of ISAR by creating a brand new logo and introduced the “ISAR Flag”

Chief Guest, Dr. Christos Coutifaris, President Elect American Society of Reproductive Medicine. Guest of Honour Dr. Rishma Pai, President Federation of Obstetric and Gynecological Societies of India, immediate past president Dr. Narendra Malhotra, immediate past honorary secretary Dr. Prakash Trivedi, organizing chairpersons of this conference Dr. Poonam Loomba and Dr. Maninder Ahuja, dignatories on the dais and in the audience, past presidents of ISAR, my colleagues in ISAR, members of the Industry, members of the media, my friends, and my husband, Dr. Sushil Shah.

I congratulate Dr. Narendra Malhotra, Prakash Trivedi and team for a marvellous program through the last 14 months and Dr. Maninder Ahuja, Dr. Poonam Loomba and their teams, for having organized this brilliant meeting which I am sure all of us will truly enjoy! It is my privilege to take charge as President of the Indian Society of Assisted Reproduction, and I accept this honor with humility. I affirm that I, along with the honorary secretary of ISAR, Dr. Ameet Patki and my team, will do our best to further strengthen this very prestigious professional Organization of experts in the field of Infertility. India has a strange problem. On the one hand it has the burden of high fertility which the Govt. is handling effectively through various family planning programs, and on the other hand we have the problem of infertility, with about 15 % of currently married women being infertile with serious demographic, social and health implications. The Global Journal of Medicine and Public Health has reported that infertility leads to increased maternal and reproductive health problems, increases violence against women with significantly higher divorces among infertile women than those who have proved their fertility.

The study has also very elegantly shown that the differences in childlessness depends on whether they live in urban cities or villages, their religion, caste and tribe, and their socio-economic and educational status. Infertile women also face immense emotional and psychological trauma, as culturally, infertility is a social stigma in our country.

Infertility is a huge social problem for women in India, whether the infertility is due to causes within a woman or her husband, it is she who is targeted, she is the one who has to visit her gynecologist and reveal her most private information, not once, but multiple times to different people in the clinic, she is the one who is answerable to everyone asking her "When are you planning to be pregnant?"

If assisted reproduction such as IVF is required by a couple in rural India, the couple may have to stay away from their homes in order to manage the frequent visits to infertility clinics which are far away from their homes. Hence the entire cost of treatment goes up tremendously, which includes the cost of medical treatment, cost of travel including stay to the city of treatment, with the added loss of income due to absenteeism from work. In order to avoid this loss to them, ISAR needs to reach out to them rather than them travelling to seek fertility providers. Hence it is necessary for us to encourage and train healthcare providers to ensure the highest standards of care. On the other hand, in the urban areas, especially in the lower socio-economic group, whilst couples undergo treatment, women may have to take leave from their jobs, or take some time off from their careers in order to reach the clinics, as and when required, only because biologically it is they who get pregnant. Besides not many can afford the costs involved and if they are desperate to get pregnant, with a possibility of affording only 1 cycle of IVF, they may agree to any kind of unindicated treatment such as egg donation, sperm donation, embryo donation, only because they are under extreme pressure to get pregnant. We need to have better monitoring, vigilance and surveillance to ensure safety standards for women across India. This will help IVF Centers to function with the best standard of care and practices. As an Indian I feel very proud that ISAR has advanced so well the field of Assisted Reproduction. We have made huge strides in reaching out to women but we need to ensure that our field maintains a high level of a professionalism and accountability by reporting to our Registry NARI, which will help us to offer Indian data and be part of the Global arena. As an exceedingly concerned Indian first and a doctor later, I feel it is important to address these issues. As President of ISAR, I would like to dedicate 2017 as "ISAR’s year of Empowerment: through Education, Ethics and Empathy".

My mission will be to bring this agenda center stage by raising awareness on it and advocating for women’s reproductive rights, which include access to treatment for infertility. I understand that the nation needs to focus on controlling our population and reduce maternal mortality, but in the process we cannot neglect the problem of infertility! Because when we treat infertility, women get pregnant and have a healthy start. Both these areas go hand in hand and are integrated. Our field makes women pregnant, and we need to ensure that multiple pregnancies are prevented and we should contribute to healthy pregnancies. We need to help to reduce maternal mortality, and morbidity, such as secondary infertility, which results from an infected delivery or abortion.

I have this agenda uppermost in my mind and it is through ISAR, that we will exchange our views with the Government on how we can take this agenda further. Every woman and man has the right to attempt a pregnancy, and IVF has given millions of couples a child of their own, and we need to respect their rights.

There is an urgent need to include coverage for infertility services for women who are covered by health insurance, so that they can take a break from their jobs in order to undergo such treatments. This will prevent them from facing a double financial loss, of paying for their treatment and losing the financial support of their jobs. The Insurance Sector needs to be motivated to cover costs related to infertility treatments as is seen in many western countries. Similarly we need to assist rural women by offering safe infertility services through public private partnerships with infertility clinics, which are accredited by a Professional Organization, such as the Indian Society of Assisted Reproduction (ISAR).

Newer technologies are developing very rapidly in the field of ART, and as IVF specialists we need to be constantly updated, so that we can offer the best of care to our women. Let us act by practicing evidence-based medicine and not get swayed to be the first in offering a technology, which may not really be the best for our women, men and their future children. Let us be ethical in our practices, for the good of our patients and for the good of our population. We in India need to be self-regulated, because we are not monitored by agencies such as HFEA in the UK. Till such agencies are in place, we must remember, that we are being monitored by someone more Supreme up there! As infertility treatments are very basic in Government and Municipal hospitals where most of our budding doctors train and become gynecologists, they only learn this science theoretically and have very limited practical experience on managing infertility with assisted reproduction. Education is one of our agendas this year and ISAR will take up this challenge through this year.

There is a need to offer good postgraduate courses to them including fellowships and mentorships with experienced clinics, for them to learn this art. ISAR is the body which Is doing its best to offer such training which is gradually getting very popular and during my tenure I will be initiating many more such programs. ISAR is a mature Organization which needs its own identity. I would like to launch the new ISAR Logo which stands for "Integration of various disciplines towards one common goal of making an infertile woman pregnant" and our own "ISAR Flag"

I would like to quote my favorite hero "Mahatma Gandhi" who said "You may never know the results of your actions, but if you do nothing, there will be no results". Keeping his spirit in mind, let’s act, today!

I would like to end by thanking all those who have walked with me through my journey and will continue to walk with me. I thank all of you for being here to share my thoughts and the responsibilities we have towards our women. I am sure all of you who have affirmed your confidence in our team will support us, because without your support, we will not be able to deliver. Our team at ISAR will work hard for all of you and make sure that all of you get what you aspire from ISAR.

I would also like to thank

  • all my colleagues who will take our agenda forward through the year.
  • all our industry partners for supporting our initiatives through the year.
  • my team at Gynaecworld
  • and my family members who have always encouraged me to do even better.

Dr. Duru Shah
President, ISAR

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