Liquid nitrogen supply. Fertility clinics worried over impact of drop in liquid nitrogen supply

The government’s decision to convert existing nitrogen plants to facilities producing medical oxygen – required for critical Covid-19 patients – has triggered anxiety among those who are engaged in offering assisted reproduction services, as the sudden shortage in liquid nitrogen could hit eggs, sperm and embryos cryopreserved in thousands of IVF (in vitro fertilisation) centres across the country.

“The IVF centres require a stead supply of liquid nitrogen for preserving embryos, eggs and sperm at ultra-cold temperature (minus 195 degree Celsius) conditions. There is some uncertainty whether the centres would be able to get liquid nitrogen in adequate quantities if these plants are converted to those producing medical oxygen,” said Nandita Palshetkar, a Mumbai-based gynaecologist who runs eight fertility clinics across the country.

Shortage of oxygen

Reeling under acute shortage of medical oxygen as the second wave of Covid-19 hit many States simultaneously, the Centre last week decided to explore the possibility of turning liquid nitrogen plants into those producing oxygen.

Getting sufficient supply of nitrogen may not be a problem for major cities like Mumbai or Delhi, but what about tier-2 and tier-3 cities where a large number of IVF facilities operate, she asked. Assisted reproduction is growing in India where there are at least 3,00,000 cycles a year, said Dr Palshetkar who herself has around 30,000 eggs under her custody.

Professional bodies such as the Indian Society for Assisted Reproduction (ISAR), the Indian Fertility Society and the Federation of Obstetric and Gynaecological Societies of India (FOGSI) have appealed to the Central government not to divert liquid nitrogen plants to produce oxygen as the survival of cryopreserved embryos depends on uninterrupted supply of liquid nitrogen.

“With an increase in infertility, IVF has become very popular among young couples. Apart from that, many young people affected by cancer preserve their gametes (egg cells or sperm) so that once the cancer treatment is over, they can go for embryo transplantation for having a baby,” said S Shantha Kumari, a Hyderabad-based IVF specialist and President-elect of FOGSI.

“There are some reports that in some places they would convert these liquid nitrogen plants to oxygen production plants. But we really do not know what sort of back-up plan the government has for ensuring the supply of liquid nitrogen to the IVF centres,” said Kumari.

Cryopreservation

According to Kumari, each IVF facility roughly requires 8,000 litres of liquid nitrogen a month for meeting its cryopreservation requirements.

“For patients who have preserved their embryos, oocytes or sperm, it is their life, their future,” she said. Palshetkar, who would soon take over the President of ISAR, however, agreed that there is an ‘ethical conundrum’ when the choice is between dying patients and unborn lives. “But they (embryos) are also a future investment made by people,” she said.