Cord Blood Banking: Expensive whim or useful tool?

While it is quite popular in western countries, Cord Blood Banking (CBB), a relatively unknown phenomenon until a few years ago, has surely come of age in Urban India.

Since time immemorial, the umbilical cord and blood have been discarded immediately after birth, as they were deemed to have no value once the baby is out. However, with exponential advancement in medical research in the field of genetics in the past decade or so, the concept of CBB has garnered ample interest lately. Today you can arrange for the cord blood and cells to be harvested during birth, and preserved for 21 years. The blood/cells can be used for medical therapy in curing various diseases, not just for the baby from whom it was extracted, but also its siblings, parents or even grandparents.

Why does one need CBB? Blood and stem cells found the in the umbilical cord binding a mother and baby have been used in studies to cure cancer, blood related and other congenital diseases. So if you have a family history of such diseases, chances are that going for CBB can help the baby and possibly other related family members with the diseases. But what if you do not have a history of these diseases? Medical researchers are looking at expanding the use of the stem cells to cure other diseases as well, like heart disease, diabetes, strokes etc. It is expected that with time, the uses of cord blood will increase manifold.

However, there is also a flip side to CBB: Currently cord blood cells can help with limited diseases only, and although research promises more uses in time, some people may not find that a good enough reason to go for it in case they do not have history of blood/cancer diseases. Secondly even if there is a family member with a disease that can be addressed by CBB, the cells may not be a match and hence be useless for that case. Last but not the least, there is a cost involved with CBB: anything from Rs 75000 to Rs 500000 for preservation for 21 years; depending on the processing method and multiplication of cells required.

So what's the verdict on CBB? I asked a lot of first time moms in my pre-natal class. Many of them were aware of CBB and had signed up with some or the other bank. Some were still thinking about it. There were also others who did not seem to like the idea, and had flatly refused to go for it. Either ways, everyone knew about it, even if they did not opted for it. When I asked the Lamaze instructor, she refused to comment, saying that she doesnt believe in promoting or snubbing CBB as its not a well established enough practise yet: it is up to the couple to take an independent decision. My gynecologist was more forthcoming: he was clear about the limitation of uses but still suggested we think about it, in case it ends up helping. Most of his patients - young, educated, urban couples in Mumbai, are going for it these days. He however refused to promote a particular bank and requested us to make a choice based on own research.

Personally, being the MBA couple we are, we applied game theory to make this decision:
it was better to go for it just in case it comes handy, if it doesnt then it's just a small affordable cost. But in case it could be used and we did not go for it, the loss will be much more.

And so we did our research and educated ourselves with the cord blood banks in India, the uses of CBB, actual success stories, various options/costs/payment methods, references from people who have done it etc. And finally we zeroed-in on CryoBanks.

So what happens once you finalise a bank? You contact them, they come over with a presentation and lots of material for you to read on the theory of CBB and actual application and success stories. They also inform you about the benefits and limitations, the way they process and preserve the cells, their policies and costs, and various options depending on your needs. Once you are on board, they take a detailed note of medical history of both mother and father and their families. Once the agreement is signed and all paperwork finished, they provide you with a collection kit which you need to carry as is to the hospital when you go into the labour. Most good banks have tie-ups with all the major hospitals in major cities, and the hospital staff is well aware of the protocol. The moment the mother goes into labour, she is to inform the bank, so they can come in time and collect the blood/cells. It takes hardly a few minutes and is a safe and painless procedure. Once teh samples are collected, they are tested to see if they can be preserved. In case they cannot, any money paid is refunded minus basic expenses. If all goes well, the blood/cells are banked and you get regular updates on the status. At the end of 21 years the agreement lapses but can be renewed if required.

Ideally people bank the cord blood/cells from the first baby. If a couple has more than one children, it is generally considered a waste of money to bank their blood/cells as well, as the amount of stem cells that can be multiplied and used from the first baby are enough to help the whole family. However, in case the first sample doesnt yield results for a family member due to matching issues, people may undertake CBB for second/future children too.

So what to look for in a cord blood bank:

• it should be well reputed with experience in the arena
• it should have state of the art facilities for preservation
• it should have a good network with hospitals and easy to reach customer support
• it should have transparent and customer friendly agreement and policies, and no hidden charges

What options does one have in India? The top three cord blood banks (basis popularity) are:

CryoBank , LifeCell , CordLife

In the end, irrespective of research and expert opinion, CBB is a highly personal decision that every couple today is faced with : it is like having a bio-insurance. It pays off if it comes handy in case of a disease. If it doesn't, it was just payment for insurance. And that's a call everyone takes when the time comes.