MoHP drafting policy on infertility

LAXMI MAHARJAN

KATHMANDU: The Ministry of Health and Population (MoHP) is drafting a policy on full and partial infertility to provide a legal, ethical and technology basis to infertility issues.

Dr Babu Ram Marasini, chief of the health sector reform unit at the ministry, said the ministry is drafting the policy to address the use and methods of artificial reproductive technologies.

He said the policy will incorporate legal issues of surrogate mother, biological father, test tube baby and other Artificial Reproductive Technologies (ARTs).

ARTs are methods used for making women pregnant by artificial means in case of infertility. Fertile couples could also use it for genetic reasons. Artificial Insemination of Husband, Artificial Insemination Donor and In- Vitro Fertilisation (IVF) are some of the ART methods practised in Nepal.

The country does not have any legal backing for surrogate mother, biological father and ARTs, which may create problems related to property rights, citizenship rights and protection rights, said Marasini.

The pregnancy followed by ARTs could bring many ethical, technological and legal challenges in the country, he said, stressing the need for laws governing IVF.

According to the ministry, three per cent of women in Nepal are estimated to have fertility-related problems. Globally, infertility is estimated three to five per cent.

Problems that cannot be managed by medical, surgical and hormonal therapy might need assisted reproductive technology for reproduction, Dr Marasini said.

“ARTs must be introduced in the country to address the situation of infertility.” There is a need for ethical guideline and policy for ART practitioners.

Dr Marasini stressed the need to establish a national embryological authority to handle the issues of infertility. The causes of infertility are – congenital (genital birth defects) and acquired (genital infections), including sexually transmitted infections and lower abdomen surgery, Dr Marasini said.

Rishi Rajbhandari, an expert on public health law, said the ministry is also drafting a policy to stop commercialisation on the name of infertility treatment. Some of the ways to address infertility are adoption, divorce, voidable/additional marriage and surrogacy.

“Nepal has no legal provision to deal with surrogacy and this has given rise to debate over legal identification of surrogacy,” Rajbhandari said.

The court has decided that ‘a surrogate child should have the same rights as a biological one and should be entitled to parental property, he further said. There is no legal identification of infertility centres in the country, which are established under the provision of health clinics.

According to Dr Uma Shrivastava, reproductive endocrinologist at the Infertility Centre Nepal, medical practitioners dealing with infertility are in a dilemma due to the lack of guidelines.