IVF regulations pose barrier to infertile couples

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Experts say regulations on in vitro fertilization issued by the health ministry in 2003 need to be revised.

Early this month K. and his wife traveled from the US to the Ho Chi Minh City-based Hung Vuong Obstetrics Hospital to have an in vitro fertilization (IVF) treatment.

K. said they have had IVF once in the US and once in Taiwan, but failed both times. Hearing about the country's great development in IVF, they decided to try their luck in Vietnam.

But all the local hospitals, including Hung Vuong, refused to grant their wish, because K.'s wife is 47 years old, two years older than the 45 year age limit as regulated by the Ministry of Health (MoH), he said.

Although they convinced the doctors by saying that the wife would give birth to the baby in the US, where they would not be bound by the regulation, the answer was still no, he said.

While the demand for IVF increases by 10 to 15 percent each year, K. and his wife are one of the many couples who are not eligible for the program, Ho Chi Minh City Reproductive Endocrinology and Infertility Association (HOSREM) General Secretary Dr. Ho Manh Tuong said.

Doctor Nguyen Thi Ngoc Suong from Hung Vuong Hospital's Infertility Department said the age regulation is the most common stumbling block to infertile couples.

There are numerous reasons couples come to have IVF when the wife is over 45, Suong said.

Some women get married late, while some couples only turn to IVF after years of failed attempts at a natural pregnancy.

Also IVF doesn't work immediately for many women who may have to try for a couple of years, according to Suong.

"Some women start IVF when they are less than 45 years old, but they are over 45 when they have embryos transferred to their uterus," she said.

A doctor who wished to remain unnamed said in such cases, although doctors want to help them, they can't flout the regulations.

"The regulation that women must be not older than 45 when having IVF needs revision, because the regulated age is older in some countries," Tuong said.

Anonymity counts


In Ho Chi Minh City:

* Tu Du Obstetrics Hospital

* Hung Vuong Obstetrics Hospital

* Saigon International Obstetrics Hospital

* Van Hanh Hospital

In the central and northern regions:

* Hue Central Hospital

* Thanh Hoa Obstetrics Hospital

* Hai Phong Obstetrics Hospital

In Hanoi:

* National Hospital of Obstetrics

* Hanoi Obstetrics Hospital

* Military Hospital's Embryo Technology Center

An IVF costs between VND30-40million (US$1,749-2,332).

Under MoH's regulations, sperm donors and receivers are not allowed to know each other's identity.

The ministry, however, should assess whether to reveal the identities on a case by case basis, because some couples want to use relatives or friends as sperm donors, Tuong suggested.

For example, H. is infertile and wants to use his younger brother's sperm for his wife's IVF, but the anonymity regulation does not allow it.

Doctors said many single women want to have babies through IVF with sperm from men they know, but are not permitted to do so.

They also mentioned surrogate mother regulations as a barrier for many infertile couples.

Suong said women with uterine problems who cannot have a pregnancy sometimes want their sister to have a surrogate pregnancy with their own eggs and their husband's sperm.

Once again the regulation does not permit it, although doctors know they are family members, not being paid for a service, she said.

Tuong said MoH has asked IVF centers to make proposals about the shortcomings in IVF regulations and will consider them.

"We have collected and proposed ways to the ministry to overcome IVF regulation-related shortcomings to meet the demands of many couples," Tuong said.

Over the past 10 years, ten IVF centers have been established nationwide producing more than 4,000 IVF babies.

Reported by Thanh Tung

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