Is this ART Amendment Act 2021 is boon or bane, this is a million dollar question. And it need to be addressed with proper justification and logic. Let’s find out how it effects and acts.
The Assisted Reproductive Technology (Amendment) Bill 2021 by voice vote in Lok Sabha as the amendments moved by some parliamentarians, recently. The ART Bill seeks to regulate fertility clinics. All such clinics will have to be registered under the National Registry of Banks and Clinics of India. The Union Health and Family Welfare Minister Mansukh Mandaviya said this Bill was sent to the Standing Committee and the suggestions of the committee have been considered in this Bill. “We respect doctors, but any unethical practice will be punished. Sex of the child cannot be revealed. In many Acts, the punishments are clearly mentioned for unethical practices by doctors,” the parliamentarians said.
Every woman, above 21 years of age can now become a mother with this Bill. Even divorcees and widows can use the ART Bill. Earlier, Congress MP Karti Chidambaram highlighted the existing lacuna in the Bill and also asked that if the donor was anonymous then why to take their Aadhaar number. “Will there be a contact tracing if the child wishes to do so after turning adult? ” he asked and also questioned about the pricing regulation as this treatment cost a huge money.
Raising the issues of LGBT couples and single men from using this technology, Chidambaram also said that every Indian who is physically and financially fit to parent a child should be able to be a parent. He also raised his objection to the provision that only married women who had a child should be a donor. Supporting the Bill, BJP MP Heena Gavit said that the majority of the In Vitro Fertilization (IVF) clinics or centres have not been registered with Indian Council for Medical Research (ICMR) and there was a need to give insurance coverage to the surrogate mother.
The Bill passed in Lok Sabha last week, was also approved in Rajya Sabha on Wednesday. The Bill will regulate the in-vitro fertilisation (IVF) practice in India and prevent mushrooming of unauthorised IVF clinics in the country, experts said. It seeks to regulate fertility clinics, ART banks, prevent misuse, adopt safe and ethical practises. It also proposes the establishment of a national registry and registration authority for all clinics and medical professionals serving in the field.
“The field of Assisted Reproductive Technology has been unregulated for a long time and has seen a proliferation of ART clinics and banks that have been running unchecked. This has led to unethical practises and commercial exploitation at the cost of women’s reproductive health. Regularisation of this space through mandatory registration and standard operating procedures for private clinics is a welcome step,” Poonam Muttreja, Executive Director Population Foundation of India, told #KhabarLive. “The Bill will regulate IVF practice in India and prevent mushrooming of unauthorised IVF Clinics. The bill will ensure that clinics have the basic requirements of embryologist and clinician which will be full-time and also the laboratory infrastructure machinery and properly conducted consulting and counselling. It will make sure that patients are offered the best treatment and not treated by people who are untrained in this field,” added Dr Kaberi Banerjee, Medical Director of Advance Fertility & Gynecological Centre, New Delhi.
According to the Union Health and Family Welfare Minister Mansukh Mandaviya, every woman above 21 years of age can now become a mother with the new Bill. Even divorcees and widows can use the ART Bill. “The Bill will work towards empowering couples by making better and more information available to them about treatment options which will help improve awareness; improving patient safety and improve awareness about patient rights,” Dr. Prof. (Col.) Pankaj Talwar, VSM, Head, Medical Services Birla Fertility and IVF, told IANS. However, experts noted that implications of the bill for categories of individuals other than married couples needs further clarity. “The government should ensure that single parents and the LGBTQIA+ communities must not be excluded. We call upon our elected representatives to be more compassionate to all aspiring parents regardless of their marital status and identities,” Muttreja said. The Bill also addressed the issues of reproductive health where ART is required for becoming a parent or for freezing gametes, embryos, embryonic tissues for further use due to infertility, disease or social or medical concerns and for regulation and supervision of research and development. It has also fixed the number of attempts an egg donor can give her eggs and put a stop on commercial egg donation. However, the facility may not be available in smaller cities, the experts noted “We welcome the ART Bill to protect the interests of all parties but there are several provisions that are troubling. Due to severe increase in paperwork and administration work the cost of treatment will go up and will affect the poorer section of society more who will then have no option. Those couples who need donor egg or donor gamete will have reduced pregnancy rates due to lesser number of eggs collected from the donor,” Dr Shivani Sachdev Gour, Director of SCI Healthcare, IVF expert and Gynecologist, said. “Though, the Bill aims to ensure proper treatment is provided to the public in general but how these will be implemented will be a challenge for the government and stakeholders,” Banerjee said.
Now, we will know, what’s ART? Assisted Reproductive Technology is about helping ‘childless’ couples realize their dream of having children thru medical assistance. It includes all techniques that seek to ensure pregnancy by handling the sperm outside the human body and transferring the gamete (sperm or egg) into the reproductive system of a woman.
Need for regulation It is estimated that around 2.8 crore couples in the reproductive age group in India are infertile. Of the people seeking remedy for infertility, 20-25% undergo in vitro fertilization treatment. Needless to say the Assisted Reproductive Technology (ART) practice has grown rapidly in the last few years and India has registered the highest growth in the ART centres and the number of ART cycles performed every year.
Over the years, India evolved into a major ‘Hub’ of this global fertility industry with reproductive medical tourism becoming a significant activity. Clinics in India offer nearly all the ART services—gamete donation, intrauterine insemination (IUI), In-vitro fertilization (IVF), Intracytoplasmic sperm injection (ICSI), Pre-implantation Genetic Testing (PGT) and gestational surrogacy. The reproductive segment of the Indian medical tourism market is valued at more than $450 million a year and was forecast by the ICMR to be a six billion dollar a year market in 2008. India’s fertility industry in is an integral part of the country’s growing medical tourism industry, which experienced 30% growth in 2000 and 15% growth between 2005 and 2010.
Such frenetic growth entailed many legal & ethical issues due to excessive commercialization and lack of standardized protocols. As there were only guidelines of ART, and but no law existed to address medical, ethical and legal aspects of ARTs. India needed to ‘regulate’ ART practice. A monitoring mechanism to prohibit unbridled commercialization and rampant ‘rent a womb’ business where vulnerable women became victims.
Bill Seeking Regulation introduced in 2020 As a response to this need and urgency, the ART Regulation Bill was introduced in Lok Sabha on 14th September 2020. On 3rd October, it was referred to parliamentary standing committee on Health and Family Welfare. The Committee had extensive consultations with wide stakeholder group and submitted its report on the 19th March 2021 to Rajya Sabha. On 14th August 2021, the official amendments to the Assisted Reproductive Technology (Regulation) Bill were approved by the Cabinet.
The bill seeks to regulate the ART services by preventing commercialisation & protecting women from exploitation, ensuring rights of all those involved. Most importantly the proposed legislation aligns with the medical termination Pregnancy ACT and the PCPNDT Act (Pre-conception & Pre natal diagnostic techniques act 1994). It also supplements the Surrogacy Regulation Bill 2020 passed by the Lok Sabha.
Recently, some members of Lok Sabha aired their concerns and demanded amendments to the proposed bill. Concerns on ‘affordability of treatment, privacy of data, accommodating LGBT community, single women, National & State Boards composition, safeguarding rights of Donor, Woman and the Child, providing Insurance, creating world class facilities with the help of qualified medical experts at ART centers were all agreed to by the minister.
The concerns expressed by a member about the bill being patriarchal and has the potential to promote eugenics were but ignored by the house at large. As the subject itself is highly complex with different countries adopting various methods suited to them based on their cultural ethno demographic trends and fertility rates Indian ART Bill remained centered on issues specific to our country.
This path-breaking bill not only safeguards women’s reproductive rights and a child’s genealogy, but also demonstrates that India is agile enough to align with the fast-changing world, the social context and technological advances. By passing the Assisted Reproductive Technology (Regulation) Bill, 2020, India proves yet again that the country is indeed future ready. #KhabarLive #hydnews