OUR CONTRIBUTION TO THE DEVELOPMENT OF IVF IN INDIA--DR DASTIDAR SHARES HIS EXPERIENCE

Our Initial Struggle since 1982The story how IVF came to India (Kolkata) involves a considerable number of personal details which are included here only because they are excellent illustration of how programmes of this kind come about.Today, I would like to share with you the inhuman effort we had to put to develop clinical IVF programme in Kolkata. Extreme power cut, lack of technical knowledge and zero supply line of so many disposables, media and equipments needed for IVF programme, made our struggle in the early 80’s unimaginable. Learning by Trial & Error Since we did not have any knowledge how to identify human egg or the associated laboratory procedures for IVF, we had to learn from scratchI was entrusted with the responsibility to develop basic laboratory aspects like, Oocyte identification under microscope. To set up basic embryology laboratory for sperm preparation, fertilization, embryo-culture, quality-control procedures practically the whole laboratory work-up.

Ovulation induction regime, monitoring of ovulation and Laparoscopic oocyte retrival procedures were being developed by Dr.(Prof.) B. N. Chakravorty.He used to aspirate follicles laparoscopically at a Central Calcutta Nursing HomeI used to travel initially, to Jadavpur University & later, to Indian Statistical Institute, where I was trying to identify the oocytes microscopically from the blood mixed follicular fluid. Thus, some days I had to work for the whole day till midnight trying to identify an oocyte and finally nothing could be seen. However with my unusual energy of youth and motivation, it was possible to venture the areas of IVF science, which was almost unknown to the scientific community of this part of the world.


To minimise the distance between nursing home & laboratory, I established a primitive laboratory with technical support from Dr.(Prof.) Subir Dutta in my study-room at my residence (79/28 L.C. Road) which was at five minutes distance from the nursing home.This is where I was finally able to identify and isolate an oocyte. My next challenge was of fertilizing oocytes with sperm.Since we did not have modern CO2 incubator, I tried various improvised techniques to achieve the required tissue culture environment i.e. 5% CO2 in air. Finally I devised a glass jar with premixed 5% CO2 in air to undertake IVF and embryo culture.
After numerous failures, I was finally able to culture fertilized oocyte in vitro resulting in cleaving embryos (2-8 cell stage).•Severe powercuts in Calcutta in 1982-83 largely hampered our work. •None of the disposables like petri dishes and equipments were available in India and thus myself and Prof. B.N. Chakravorty used to carry these items on our way back from several international conferences.
Our first IVF pregnancy
• Following transfer of cleaving embryo to recipient uterus, one Mrs. Devi conceived in 1983 in the same laboratory at my residence.
• This was reported to IMA, ICMR and Govt. of West Bengal. We jointly presented our data in 3rd world congress on IVF, Helsinki, May1984: Ref. Chakravorty, B.N. & Ghosh Dastidar, S, 3rd world cong. Scientific Abstract Book (This was the 1st successful IVF report from India in international level).
First child birth from our IVF programme
• With this initial success of achieving pregnancy following E.T. a relatively improved laboratory was developed in C.I.T. road, adjacent to Dr. Chakravorty’s chamber.
• Finally we succeeded delivering a healthy male baby by IVF procedure in Nov19,1986. Interestingly, this birth was possible using the same tissue culture chamber devised by me in 1983. In same year a Bombay group also delivered an IVF baby in July
Calcutta’s Second Successful IVF Programme initiated by me in 1991•Along with IVF, I took up the project of GIFT and delivered the first baby in 1992
•In 1994, the most advanced research of ICSI was started here. India’s first ICSI- ZIFT baby was delivered on 31st March, 1995 from this center.
•In 1998, we delivered eastern India’s first PESA-ICSI baby.

Against all odds, a successful clinical IVF program was developed in Kolkata from a very humble beginning with lot of improvisation during 1982 to 1986. This could be a role model to our juniors intending to take up medical research as a career.Most commonly practiced ART procedures are IVF and ICSI After the birth of 1st IVF baby in 1978, ICSI is the single most major breakthrough in ART research since it is very efficient in all varieties of male infertility where conventional IVF is unsuccessful.Current research is directed towards:(i) Improving implantation rate(ii) Reduction in the incidence of multiple pregnancy (as it is associated with higher Incidence of neonatal morbidity and mortalityOur results suggest that pregnancy and delivery rate is comparable in IVF and ICSI. ICSI appears to be the preferred mode of ART whenever there is an associated male factor present. However as seen in our comparative data, ICSI has a relatively longer leaning curve (1-2 years).