Subhra Kar 
Perhaps empathy along with passion was the driving force for Dr.Lipsa Mishra, which has made her a known name among the IVF specialists in the state.
During her glorious career of around 10 years, Dr. Mishra has set several benchmarks in her field at several points. After completing her MBBS from SCB Medical College, Cuttack with double Honors in physiology and pharmacology, she went on to do her senior residency at AIIMS Bhubaneswar, and ever since she has been practising in Bhubaneswar. This October I have joined Birla. Since 2017 I have been practicing in IVF only in Bhubaneswar.
Dr. Lipsa has been a consultant OBGYN at Sadguru Medical and Research Center in 2013. Thereafter she was the Senior Registrar at AMRI Hospitals Bhubaneswar. Till 2017, she was the Senior Resident in the Department of O&G, at AIIMS Bhubaneswar. After which she moved to Indira IVF Bhubaneswar, as Senior Consultant Reproductive Medicine and became the Clinical Head (Eastern Zone) Indira IVF Hospital Private Ltd. In October last year, Dr.Lipsa joined Birla IVF and Fertility Bhubaneswar. As a fertility expert, in the last 7 to 8 years, she has covered 500+ cases in therapeutic hysteroscopy, 2000+ IVF cases and 1000+ IUI cases.
We had a fruitful interaction with the iconic physician and got a chance to peep into her world as well know about the changing trends in IVF.
1.) First of all, we would love to know about your journey. What motivated you to become a doctor and how did you reach where you are today?
If I have to say what motivated me, in my family we had two doctors previously and while growing up around them, I saw their way of living, their approach towards everybody, the empathy they had which really touched me. Since my student career only I didn’t think of any second plan. The only plan in my mind was to pursue a career in medical science. But if you ask me why I became a gynaecologist, that was when during my MMBS career, I have realised after seeing that females are very much neglected in the family. They have a plethora of problems. I really wanted to do something for them, so that’s when I thought about taking gyanaec as a subject. And then comes the super speciality,that why chose in Fertility. Usually in our routine practice we had around 20-30% couples complaining about not being able to conceive, while there were a lot more people coming to us for an abortion. But, aborting a life which the nature has given you, didn’t please me. Rather I chose to help the other group, who are not able to conceive and that’s how I came this far.
2.) There are several misconceptions in the minds of people surrounding IVF. Would you like to throw some light on the process besides its healthcare and financial feasibility?
The IVF is a simple procedure. Just that it takes some time, so it seems prolonged. But basically IVF involves removal of the eggs from the body, So that we can study them we can select the good quality egg and then use for fertilisation. What we do is, using certain hormonal injections on the female from the day 2 to 3 of the cycle, the size of the eggs are increased and made mature. And then after 10-15days under general anaesthesia via a needle only trans-vaginally we collect these eggs. Under the microscope we select the good eggs and the same way we select the sperms also and we fertilise them. Again, the fertilisation can be carried in two ways one in conventional form of IVF and another is the ICSI which is the advanced form of IVF. There we do the fertilisation ourselves. Once eggs are fertilised, we have embryos with us which are frozen. And then we prepare the uterus of the female. When the lining of the uterus seems good we transfer the embryos into the uterus vaginally.So the process is simple actually, but it takes a time period of 1or 2 period cycles.
IVF as such doesn’t have many side effects. It isusually the side effects related to the injection.Like at the injection site there may realise little bit of redness or itching which are now very less due to improved quality of injections and the changing mechanism. Besides, there might be bloating for the patients who have gastritis or abdominal discomfort just like during the periods. So that is what usually accompanies with the IVF procedure otherwise the incidents of serious complications, I may say it is less than 0.1% as per the statistics.
Since the procedure involves around 10-15days injection and use of advance technology like ICSI and growing embryos outside your body then storing and freezing them, in average at a good centre with all these advance facilities,the average cost of 1 IVF cycle ranges from 1.2- 1.5 lakhs.
3.)As we know, you have handled over 2000 IVF cases in your career. How popular has it become in Odisha? Are there any hindrances or stigma in this direction?
All the cases I have handled so far were from Odisha only. So I would say the awareness has increased a lot. Before five to ten years, the age group of couple which used to come or also inquired about all these facilities was after 40 years of age, like people approaching menopause. But now a days I think couples as young as 25-30 too are coming and inquiring what all facilities are there what are the treatment option so the awareness definitely has shot up. Thanks to the social media, the awareness campaigns going on everywhere. But yes the incidence of infertility also very high now a days. Around 15-25% of couples are suffering from this at some point of the time. And mostly if I may add, the male infertility is rising much more. Every day in our outdoor, we found 6 out of 10 couples suffering from infertility mostly due to female problem or a female centric problem, but now a days even the males are going ahead.
If I may say, the cause of infertility is the late age of marriage or a planning of a pregnancy. Because for any kind of good pregnancy outcome the age of the female is the utmost priority. Post 35 years in the female the eggs start ageing and it develops genetic abnormality. So the quality of embryos which they form starts deteriorating. The right age of pregnancy is, I must say between 20-30. But it is rarely achieved now a days. The second thing is that the environment or the lifestyle which now a days the generation is involve with, like a sedentary life style, consumption of junk food, increasing incidence of obesity all these are adding on to the quality of sperm or the eggs of one’s body. The addiction smoking and alcohol is increasing so much that all these are deteriorating the quality of the gametes.
4.) What are the usual conditions under which couple choose to opt for IVF?
Like I said one of the major reasons these days is increasing Male infertility due to several reasons. Secondly, there is another situation called ‘Unexplained infertility’, that is the case where all the reports of the female are good but still they are unable to conceive within 2-3 years of their trying periods. So unexplained infertility is something where the test which are done from the blood and ultrasound, all are normal so you don’t know what is going wrong. Basically, the molecular defects will be there and there IVF comes to the picture because we can see the molecular picture. Then there is PCOD, where the female is having abundance of eggs but which are usually not functioning at the right time. Another is the diseases increasing by leaps and bound is Endometriosis, which is a common disease where IVF is the only treatment available for them. Another problem is fallopian Tube block, in which two tubes are in the reproductive track. If they are blocked then the sperm and egg can never meet. The only solution we can do is only IVF.
5.)In your career of almost a decade, you have certainly outshone your own achievements by working with some of the most prominent healthcare institutions. What are your plans for near future?
Future plan would definitely, I would like to be a part of or may be build an institution where we would give holistic treatment like female who can be treated for all possible problem but then I would like to institution to contribute to the research as well. Science is ever evolving. We want to have treatment which are less in business and putting less economic burden on the couples. Definitely will try to build an organisation with team work. That every problem of a female can be catered with importance on research as well.
