IVF for the poor, is it possible? My answer is yes!

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 IVF for the poor, is it possible? My answer is yes! 

Provided we start thinking out of the box.

Stop slavishly following the High-tech guidelines and regulations set in place by the wealthy sections of the society.

Stop falling in to the trap of marketing gimmicks of pharmaceutical, culture media and instrument industries.

 in a modification of Parkinson's law  '"work expands so as to fill the time available for its completion" " Use and  indications  for  an ultra-sophisticated  costly technology  expand  based on the  availability of the  equipment  and  personnel"  see the number of articles  published  on  the  real  indications  for ICSI and   what really is being  done.

Understand that you get what you can pay for

Like a Motel 6 room for $40 a night VS "Mandarin Oriental" for $1500 night

Both of them give you a place to sleep.

Even the top journal Human reproduction has a stepwise  price plan 

for open access 

"Charges for CC-BY-NC: • Regular charge: £1875/ $3000 / €2438 • Reduced Rate Developing country charge*: £938/ $1500 / €1219 • Free Developing country charge *: £0 /$0 / €0"

There is an Indian Telugu proverb

ఆకలి రుచి ఎరుగదు ,నిద్ర సుఖమెరుగదు  

Which roughly translates to hunger doesn't know taste and sleep doesn't know comfort.

A Syrian refugee or a Congolese farmer will not ask which chef prepared the food, he will grab, eat and sleep where ever, as long as his hunger is satisfied and where he is safe.

 Same is true of a poor rural Indian house wife, she is not worried about ESHRE guidelines.  All she cares is  she is able to have a child so that her in-laws  do not  burn her  alive  or ask for  divorce so that they can  have  him  married  again ( even if the problem is male infertility)

Let us take “Hair transplantation” as a template to emulate

A dermatologist evaluates a person with alopecia.

After a few preliminary tests patient is scheduled for a transplant.

Under local anesthesia many a time in the office a strip of occipital scalp is cut out (harvested, in medical jargon) this is transferred to the "LAB" where a few technicians using a microscope dissect individual or groups of hair follicles (plugs).While this is going on using a template multiple small incisions are made on the bald area of the scalp.

Once the plugs are ready under the supervision of the dermatologist the technicians insert them in to the patient’s scalp.

Tell me in all of these steps which part really needs a five year medical school and a three year dermatology residency? 

It is only because of the dogma and aura of  high technology needed for this  medical procedure and the  word " transplant " which equates this to a renal or heart transplant  that  general public is willing to pay exorbitant  prices.

If this was taught to a high school graduate in India 4 of them can easily start a hair restoration clinic where they can employ the services of an MBBS doctor for initial evaluation and general supervision and offer the same service for probably a 10th of the cost now being charged.

Similarly for low cost IVF we have a team of 

1)    Basic MBBS doctor ( DGO,M.D.Gyne); for initial evaluation 

Who will decide what ovulation protocol to use.

2)    A CNA /LVN or RN will monitor the self-administration of stimulant drugs and injections.

3)    A high School graduate who undergoes 6 months to1 year training in ultrasound imaging of the pelvis, ova retrieval and embryo transfer let us call them OT/ET techs.

4)    Level 1 embryologist who maintains a simple lab consisting of a microscope , stereo microscope regular incubator and  tubes for ova retrieval and Belgian culture

We use a simple one step medium and the Belgian technique for IVF in a tube with co2 produced using sodabicarb (cooking soda) and citric/acetic acid (lime juice or vinegar)

 I am not saying “let us demolish” The Oriental Mandarin Hotel”

I am advocating opening more Motel 6 like IVF establishments.