Pathway to parenthood

The complete guide to becoming pregnant by Dr Firuza R. Parikh. Published in 2011 by Random House Publishers India Private Limited, MindMill Corporate Tower, 2nd floor, Plot No 24A, Sector 16A, Noida 201301, Uttar Pradesh. Pp: xvii + 314. Price: Rs 299.

This book is specifically meant for aspiring parents who would like to understand the problems, rationale and the treatment they may need to undergo to "becoming pregnant.” It has a very positive approach to management of infertility among couples undergoing treatment so that the couple can look forward to a healthy pregnancy.

The author Dr Firuza Parikh is the director of Assisted Reproduction and Genetics at Jaslok Hospital and Research Centre in Bombay and is known to be responsible for the birth of more than 5,000 ART (assisted reproductive technologies) babies. The pages of the book bear her personal touch and informal style of writing that make her subject very interesting for the readers. Her interactions with patients are written with genuine feeling and she has given excellent examples of problems faced by infertile couples.

Dr Firuza Parikh: gracefully assisting reproduction

The anatomy and physiology of the reproductive system, described at length, serve as a primer before the complexities of fertility treatment can be understood. She has discussed the gynecological problems of the cervix, uterus, fallopian tubes and problems such as endometriosis, polycystic ovaries and immunological and endocrinological issues, providing a clinical and scientific explanation for the many organs that constitute the female reproductive system.

Just as well that she has devoted a chapter to treating male factor infertility, which is extremely important. It gives a sense of responsibility to the male partner and involvement in the treatment offered to the couple.

Frequently asked questions are answered and are explained in simple language with examples which are easy to understand by the couple undergoing treatment. When the scientific aspects and rationale of the treatment that is planned are known, the couple can better cooperate with the doctor. She has even covered the side effects that may arise during treatment, such as ovarian hyperstimulation syndrome (OHSS).

The couples are informed about how, why and where laboratory investigations are done. They are explained at length about Intra-Uterine Insemination (IUI), Semen Cryopreservation and banking, In Vitro Fertilization (IVF), Intra Cytoplasmic Sperm Injection (ICSI). She has even covered Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Aspiration (TESA), Testicular Sperm Extraction (TESE) which may be essential while treating subfertile males. Preimplantation Genetic Diagnosis (PGD), Intracytoplasmic Morphologically selected Sperm Injection (IMSI) and freezing for fertility are also explained. In fact the book includes a 28-page glossary explaining the technical terms alphabetically.

The last few chapters cover the problem of recurrent miscarriage, the factors that contribute to this condition and its treatment.

Many couples are worried about the possibility of ART babies being abnormal. Parikh goes to great length to assuage such fears in the chapter "Are ART babies normal?” The importance of psychological counselling is stressed for couples who face greater anxiety.

I have known Parikh for almost 30 years. Sincere and cordial to all her colleagues and patients she takes a genuine interest in their welfare. A personal touch matters a great deal in treating such patients and her empathy with those facing the stigma of being childless is palpable throughout the book. As Nita Ambani points out in her foreword to the book, "Her patients run the gamut of society from international celebrities to the poorest in our country. But Firuza treats everyone with equal compassion, grace and care… Not surprisingly, some couples have named their daughters after her.”

Among the celebrities who will vouch for Parikh being "always very gentle and encouraging” is well-known Bollywood director and dance choreographer Farah Khan who was able to deliver triplets at the age of 43 with Parikh’s guidance. In one chapter, "The Director’s Cut: Farah Khan’s Story” the reader learns of the many trials and difficulties that a woman has to go through when undergoing IVF that she describes as "a gruelling procedure.” Advises Khan, "Embrace IVF as a wonderful procedure. You will forget the pain once your babies are born.”

Besides allopathy, Parikh even delineates other options like acupuncture, acupressure, yoga, meditation, homeopathy, ayurveda, traditional Chinese medicine, naturopathy, nutritional therapy, faith and prayer. As Parikh writes in the book, "I continue to be a student of various disciplines of medicine and hence my life is full of curiosity, wonder and excitement. Also, I know that modern medicine is not the panacea it is often made out to be…

"I believe in prayer, enough to pray daily for my patients’ well being… I begin my day with prayers to God, thanking Him for all the happiness… that I have been blessed with. I know that God listens to all our prayers. That is the foundation of my spirituality. My husband Rajesh is the most secular human being I have come across. Curiously we started discussing religion and spirituality on one of our first evenings together when we were teenagers. Over 35 years of close friendship and 25 years of marriage, that discussion still continues…We dwell not just on the similarities between religions, but on their differences as well. We believe that these differences should not only be respected but celebrated as well…We are often puzzled, and sometimes amused, at the arrogance of some of our fellow humans. Sometimes on account of wealth, or knowledge, or power, humans behave as though they were God themselves. We thank God for granting us humility and pray for His guidance…

"As a devout Zoroastrian I try to live by our Prophet’s adage… Good thoughts are important for filling ourselves with positive energy. Good words make our interactions with the world pleasant. Good actions, such as work and charity, are what make our time on earth worthwhile.”

Dr USHA KRISHNA