Little Palak (name changed) seems like any other active two–year–old. Her physical and mental growth is on a par with others her age. But all of Palak’s internal organs are on the opposite side of where they should be. Also, one of her heart’s main arteries has a blockage.

The case has again ignited the debate over in–vitro fertilization (IVF).

Palak was born through IVF to a couple from Andheri who had a history of problems in pregnancy.

While research shows that IVF babies are more likely to have congenital abnormalities, many experts argue that this may be because of underlying conditions in parents.

"At 30, Palak’s mother had already had two abortions and an ectopic pregnancy," said Dr Nikita Lad, IVF specialist at S L Raheja Hospital, who treated Palak’s mother.

Ectopic pregnancy is a complication in which the embryo implants outside the uterine cavity. "I just wanted a baby. We went for IVF treatment," said Palak’s mother.

As it was an IVF pregnancy, she was tested more frequently. "In the 26th week, we found that the blood flow to the baby was not as required. We then conducted a caesarean section in the 37th week. Postdelivery, we found that all organs of the baby were on the opposite side," said Lad.

The condition the baby was born with is called situs inversus.It was also found that a main artery of the baby’s heart had a 60% blockage.

Palak is being monitored regularly and her blockage has not increased in two years.

In October, a US research on nearly 50,000 infants found that 9% of babies born with IVF had a birth defect compared with 6.6 per cent of those born naturally.

A report by the scientific advisory committee of the Royal College of Obstetricians and Gynaecologists said heart defects, cleft lips and other congenital anomalies are more common in IVF babies.

Researchers are uncertain whether the IVF process or some other factor is involved in the rise in defects. "The poor birth outcomes and complications may be a combination of treatment and underlying features of the couple, such as older maternal age," said Prof Jenny Kurinczuk, director of the National Perinatal Epidemiology Unit at the University of Oxford.

Experts say there is a higher risk of complications and multiple births with IVF

Studies show a 23% risk of premature birth. Low birth weight and congenital disorders like heart defects and cleft lip are also seen

IVF is often chosen by older women and those with health issues, who anyway face a higher risk of having babies with birth defects SITUS INVERSUS

In situs inversus, chest and abdomen organs are arranged in a perfect mirror image of normal positioning

Its occurrence is 1 in 8,500. Causes can be genetic; mostly it’s an isolated occurrence

The heart is on the right, as is the two–lobed lung.

Liver, spleen, and three–lobed lung are on the left. As the relationship between organs is not changed, functional problems are rare

Only 3% to 5% of people with situs inversus have a functional heart defect