The use of ultrasound machines for sex-determination has become passé.  “In vitro fertilisation” (IVF) is the next “in thing” when it comes to satisfying the desire for a male child.

In a jolt to Haryana’s Beti Bachao Beti Padhao (BBBP) campaign,  IVF – the process of fertilisation where an egg is combined with sperm outside the body, in vitro (“in glass”) –  is apparently being misused for sex selection.

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This IVF misuse comes in the backdrop of the sustained BBBP campaign which has made life difficult for medical professionals and quacks indulging in usual sex determination which is then used to kill an unwanted girl child in the womb.

Highly placed sources dealing with the BBBP campaign said they have reports that IVF is being misused for sex selection against the provisions of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act.

The first case of IVF misuse for sex-selection by a Panipat-based IVF center came to the notice of authorities in 2015.  Sources said this case was detected after the district authorities noticed from the ultra sound records of IVF center’s clients that “fertile” women who were already having children were undergoing IVF.

Such patients, who were having two to eight girl children already and delivered male child after IVF, were contacted by the districts authorities dealing with the implementation of the PCPNDT Act.

After these patients spilled the beans and confirmed that they used IVF for a male child. Some patients even claimed they were taken to Delhi for gender selection through IVF. Following this, show cause notice was issued to the IVF center asking why action should not be taken against it for sex-selection.

Speaking to The Statesman, the PCPNDT Act nodal officer in Panipat,  Dr Sudhir Batra, said as using IVF procedures for ensuring a male child is sex-selection is illegal, a complaint was filed against the concerned IVF center.  “Charges have been framed against the IVF center in the lower court and its registration was also cancelled by the Haryana Medical Council,” he said over phone from Panipat.

Sources said though Panipat is having four IVF centers, not a single center has been set up there since 2015 following the action taken against the one center.  “But this business (of sex-selection through IVF)   is continuing  despite all the checks in place,” said a source. They said the registration of one IVF centre in Delhi and other ultrasound center in Kundli (Sonepat) which was also illegally serving as IVF center, was suspended by the concerned authorities over sex-selection.

A senior official in the BBBP cell in the Haryana Chief Minister’s Office (CMO) said the trend of misusing IVF has gained popularity due to nearly 100 per cent success rate of the process in getting a child of desired gender. He said the IVF clinics are known to charge Rs Five to Rs Eight lakhs for the process.

“Some complaints (regarding sex-selection by IVF centers) have been received in some cases and it’s under litigation. IVF centers (indulging in sex-selection) are a challenge for sure, but it’s an on-going struggle,” Additional Principal Secretary to the CM, Rakesh Gupta, told The Statesman.

“But the honorable CM has made his mind that we should not spare this. If IVF centers are giving medicines for infertility it’s perfectly right, but if it’s being used for sex selection, we will not spare them. We will collect evidence and do everything at our disposal,” Gupta, who is  in-charge of the BBBP campaign in the CMO, added.

Sources said IVF is the next big challenge in the fight against female foeticide as it’s very difficult to detect such cases. There are about 100 IVF centers in Haryana and National Capital Region. Most of such centers are in Gurugram.

“Ultra sound centers which charge Rs 30 thousand to Rs 40 thousand for sex-determination, we can easily send a decoy to catch them. But it’s very difficult to detect such cases because a patient has to deposit about Rs Three to Rs Five lakh in advance for undergoing IVF treatment,” a district nodal official pleading anonymity.

“So all we can do is that watch their (IVF centers) ultrasound and IVF treatment records and keep a watch on the people taking treatment there. But in many cases, IVF centers are not submitting the concerned records to the authorities to avoid detection of sex-selection, “ he added.

The sources said some couples are even going to foreign countries like Thailand for sex-selection through IVF and paying Rs.15 lak to Rs.20 lakh for the same. IVF is the process of fertilisation by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish.

The fertilised egg undergoes embryo culture for two to six days and is then transferred to the uterus.  But before that through a process called pre-implantation genetic diagnosis (PGD) or pre-implantation genetic screening (PGS), which is ideally used to make sure that only a health embryo is planted in the uterus, doctors can see of each embryo, XX or XY. And thus, can implant a male embryo for a male child.

An infertility specialist,  Dr Lakhbir Kaur Dhaliwal, who retired as professor and head, Department of Obstetrics and Gynaecology, the Post Graduate Institute of Medical Education and Research (PGIMER), said gender selection  was possible through PGD and PGS.

“It’s possible. But I don’t think anybody can do it given the stringent rules that are in place to check such sex-selection. We have to provide the records of patients to the authorities,” Dr Dhaliwal, who now works for a private fertility clinic in Chandigarh, told The Statesman. On the question that even fertile couples were undergoing IVF, she said it may be done in order to detect abnormalities or metabolic problems.