KATHMANDU, Oct 9: In a recent revelation, it has come to light that the majority of in vitro fertilization (IVF) centers in Nepal are operating without proper authorization. The Ministry of Health and Population (MoHP) has issued operating permits to only nine IVF centers across the country, leaving numerous others in violation of regulations.

Currently, over 50 IVF centers are providing services in various cities of Nepal, including the capital city of Kathmandu. Many of these centers in Kathmandu are operating without the required permissions from the MoHP.

Madan Upadhyaya, chief of the Department of Quality Standard and Regulation Division (QSRD) under the MoHP, stated that only nine institutions in Nepal meet the necessary criteria and have been granted official operating permits.

The authorized IVF centers, as confirmed by the Ministry of Health, are Vatsalya Natural IVF Kathmandu, Creators IVF Nepal Kathmandu, Vardhan Fertility Center, Norvic International Hospital, Manmohan IVF Center, Nepal International and Laparoscopy, Sneha Fertility and IVF Center, Angel Fertility Center, and HAMS Hospital.

However, there are several organizations operating IVF centers in different parts of the country without obtaining the required permissions. Among those awaiting approval are Kathmandu Fertility Center, Chitwan Fertility Center, Sahara International Fertility Center, Hope and Joy IVF and Fertility Clinic in Kathmandu, Grand City Hospital IVF Center, Maya IVF Clinic, and Venus IVF Center in Kathmandu.

According to Rule 12 of the Public Health Service Regulations, 2077, private, non-governmental, or non-profit community health organizations can obtain licenses to operate test tube baby centers legally. Operating without the necessary permission is considered illegal. There have been complaints that illegally operating IVF centers are charging arbitrary fees from clients. This issue has become more prominent due to the lack of clear government regulations on IVF fees and quality standards.

During MoHP monitoring, it was discovered that many IVF centers were lacking basic infrastructure such as gynecology services, outpatient services, ultrasound services, operation theaters, and embryology laboratories. Upadhyaya emphasized that most of the centers that obtained permission did not meet the required standards. The monitoring also revealed that the infrastructure and equipment of many of these centers were insufficient.

Upadhyaya further explained that after the classification of IVF as a specialized service under the Public Health Service Act 2075 and Public Health Service Regulation 2077, the MoHP issued circulars instructing relevant organizations to operate the service only after obtaining the required operating permits. Guidelines and protocols are currently being developed to regulate IVF services more effectively.

Previously, IVF services were considered an extension of hospital services, but recent laws and regulations require them to apply for separate permissions. Operating without an operating permit is prohibited. IVF services have expanded to multiple locations in Nepal, including Kathmandu, Bharatpur, Pokhara, Biratnagar, Bhairahawa, and Butwal.

Shri Prasad Adhikari, an infertility specialist, highlighted that IVF services are a valuable option for infertile couples but can be expensive and require skilled manpower. The worldwide success rate of IVF services is approximately 30 to 35 percent, and Adhikari cautioned against IVF centers advertising a 100 percent success rate. He suggested that improving the quality of laboratory facilities could potentially increase the success rate. Adhikari also proposed that providing IVF services through federal hospitals across the country could reduce the need for childless couples to travel to Kathmandu.

Adhikari, who is also the director of Paropakar Maternity and  Women's Hospital, mentioned that IVF services were initiated at the hospital in 2068 BS and operated for four years until 2072 BS before being temporarily closed in 2079 BS. So far, 38 individuals have received IVF treatment at the hospital, with a success rate of 20 percent. Adhikari aims to enhance the success rate and make IVF services more accessible to a broader group of women, estimating the cost of IVF services at a maternity hospital to be around Rs 200,000.

 
• MoHP
 
• IVF
 
• QSRD