Gujarat IVF centres continue to act as 'boy-producing factories' with impunity

After lagging behind in the Human Development Index (HDI) and Hunger Index, Gujarat is now in the news again for all the wrong reasons. The state is faced with a skewed sex ratio that has made the legal system sit up and take note. One of the reasons for the dwindling number of girls is even more shocking — the  proliferation of fertility clinics, or IVF centres. 

According to a Ministry of Home Affairs (MHA) report, titled ‘Vital Statistics of India on the Civil Registration System, 2020’, Gujarat recorded the third lowest sex ratio in the country. With 909 girls per 1,000 boys, the western state ranked just above Manipur at 880 and
Dadra and Nagar Haveli and Daman and Diu at 898. In the 2019 MHA report, Gujarat recorded the lowest sex ratio in the country with 901 girls per 1,000 boys, followed by Assam at 903, Madhya Pradesh at 905 and Jammu and Kashmir at 909.

Within the state, there are vast differences between urban and rural areas. The Sex Ratio at Birth (SRB) in rural Gujarat is higher than urban Gujarat, say MHA reports for 2019 and 2020. The SRB in rural areas was recorded at 929, while it was 901 in urban areas. Among the urban areas, the cities with the most skewed SRB are Surat, Botad and Mehsana, which are all dominated by the Patidar (Patel) community.

Little legal action

Laws such as the Pre-Conception and Pre-Natal Diagnostic Technique (Prohibition of Sex Selection) Act, or PC&PNDT Act, and multiple government outreach programmes, have made little change to the scheme of things. 

There are multiple reasons for the skewed SBR in Gujarat. One of them is the constantly decreasing rate of registration of births across the state. Despite the state government’s efforts to gear up its machinery for registering births and deaths and training taluka statistical assistants with the computerised birth registration systems at district, taluka and village levels, the issue continue to persist.

According to a public interest litigation (PIL) filed in the Gujarat High Court, another main reasons for the state of affairs  is the proliferation of IVF (in vitro fertilisation) centres, which couples are increasingly using for selection of  male child. The mushrooming IVF centres  often engage in determining the sex of the embryo before implanting them; this helps facilitate the birth of a male child. 

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Noticeably, a PIL was filed in the High Court against IVF centres in Surat, alleging that they are involved in sex determination of embryos and thereby circumventing the provisions of the law against female foeticide. The PIL sought the court’s intervention to issue directions for the compliance of the PC&PNDT Act to stop sex determination. The PIL, filed by Apamrutyu Nivaran Sahay, a Gujarat-based NGO and social rights organisation, was dismissed by the High Court on Monday (June 5) for being not comprehensive, giving the petitioner the right to file a fresh one.

Serious consequences

“The IVF centres are doubling up as boy-producing factories,” read the petition. “The PC&PNDT Act is not being implemented and sex determination under the guise of IVF centres is being carried out unchecked. Medical practitioners are using preimplantation genetic diagnosis to choose and implant male embryos. This will have serious consequences like a never ending effect on dropping sex ratio of the state,” the PIL further stated.

Couples are increasingly seeking help from these IVF centres to have a male child. For instance, Palakben (name changed) and her husband gave birth to a male child last year through IVF treatment. The couple sought help from the local IVF centre in Anand, after not being able to conceive after seven years of marriage.

“The doctor asked my husband if the family had any preference (for a male child) and told us that it was possible to ensure a male child at additional cost. We then chose to implant a male embryo after three earlier attempts, when female embryos were conceived,” recounted Palakben.

A son, ‘hassle free’

In another case, a relative of a couple in Surat suggested they knock at the doors of IVF clinics to have a male child ‘without hassle’.

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“We had a daughter in 2019 and our family wanted a male child after that. A relative suggested to us that through the process of IVF treatment we can have one without any medical hassle instead of multiple pregnancies. We chose to implant the 10th embryo conceived at a local clinic as the first nine were female embryos,” said Ramanbhai (name changed), a businessman by profession.

Noticeably, the rate of conviction of medical practitioners under PC&PNDT Act is low in Gujarat. In the last five years, 22 out of 38 cases in Surat ended in acquittal, while five were dismissed for non-prosecution. Interestingly, there was no appeal from the government.

Low rate of conviction

In 2012, the Surat district health department had cancelled the licence of a doctor for allegedly conducting sex determination tests at his IVF clinic in Varachha area. This remains rare case.

After receiving numerous complaints, officials from the state and district health departments raided the Krishna Clinic owned by Dr Ramesh Kapadia. They seized two sonography machines and one IVF machine hidden in the storeroom.

The health officials had then also raised concern over Chinese portable devices to determine sex of the foetus that are being rampantly used across the state.

In 2017, when Congress MP Amee Yajnik raised the issue in Parliament, the Union government had sought to dismiss concerns over increasing female foeticide in Gujarat. “The data shows that in 2017, the highest number of female foeticides were in Gujarat. Has the Beti Bachao, Beti Padhao scheme failed in Gujarat?” the MP had asked. 

While refuting the claim of highest female foeticide in Gujarat, the then Union Health Minister Harsh Vardhan was candid enough to admit, “Unfortunately, I will agree with the member that the rate of conviction in which results are delivered by the court are low (in cases filed under PC&PNDT Act). If we look at the data that how many FIRs have been filed, that number is far higher.”