23 November, 2009 - As an educated woman, Pema, 29, (name changed on request) wanted a “small and happy family”. She had wished for a son and a daughter.
But seven years into marriage, she is still without a child. She had visited the hospital and, even after being on medication, for a month, Pema could not conceive. “I discontinued the medication after I didn’t see any changes,” said Pema. Without a child, Pema and her husband had adopted a daughter, who is now two-year-old. “We gave up,” she said.
However, Pema’s hope for a child was renewed when a cousin informed them about the intrauterine insemination (IUI) facility provided by IMTRAT hospital in Haa. Without wasting time, Pema had registered and is today under medication, preparing to receive the insemination soon.
Like Pema, more than 20 Bhutanese women had registered with the hospital to receive the insemination.
The hospital’s doctor, major Deepak Patil said that many childless couples are showing interest. “A week ago, there were only 15. Today, there are more than 20 with four already administered the first phase of insemination,” he said.
The process to artificial insemination involves two parts. The woman is given medication to stimulate development of multiple eggs and the insemination is timed to coincide with ovulation - release of the eggs.
The semen is used from the husband, collected either at home or at the hospital, after the husband abstains from ejaculation for about two days. Dr Patil said that, using sperm from sperm bank, could become an ethical issue and was therefore not even discussed.
Dr Patil said that a woman could be inseminated five times. “If it still fails, the option is to go for a test tube baby, which requires more training and equipment. Today IUI is the best option here in Bhutan,” he said.
However, Dr Patil said that getting IUI beyond five times could lead to premature menopause, ovarian cyst or ovarian hyper stimulation. Internet sources say that the IUI procedure can be an effective treatment for some causes of infertility in women under 41. It is not effective for couples with tubal blockage or severe tubal damage, severe male factor infertility, ovarian failure (menopause) and advanced stages of endometrosis.
Not all women will conceive after the insemination. Dr Patil said that the success rate is only 15 percent. “It isn’t that everybody undergoing the treatment will conceive,” he said. “Since the system has just begun in Bhutan, some more time is needed to reach the optimum result.”
Meanwhile, Pema will be due for the next round of medication after two weeks. “We’re planning to go to Haa next week. Hopefully this will work for us,” said Pema.
By Tashi Tenzin
