By Swati Ravichandran Shetty
Not in my wildest imagination would I have guessed that conceiving a child would be such a challenge. More than anything else, it has humbled me and taught me that the sense of control we might feel we have, over our life's events is not always true. That things are a matter of chance and there are no clear answers for many of the questions we have. Let me take you through my journey.
Soon after getting married, neither my husband nor I were thinking of having children immediately. Our parents too never asked us about when we plan to start a family. We were both working and enjoying our lives as a young couple. Soon, we got a dog - our fur baby, and life was perfect. After a couple of years, as I was approaching 30, I thought it might be a good time to start trying to conceive. So we stopped using protection and I expected to skip my period any day. A year after trying, I felt that we should see a doctor just to check if everything was in order. I still didn't think anything was wrong as we were a healthy couple. I had a timely period cycle and had no hormonal imbalance and at that point, these were the only two things I thought could cause an issue.
We met our first doc in June 2010 and did some tests. Everything looked fine. We were asked to use an ovulation monitor, a basal body thermometer and try naturally and were put on some vitamins and mineral supplements. We were hopeful that something would happen soon.
After 6-8 months, when nothing happened, our gynaecologist suggested I do our first IUI (Intra Uterine Insemination) to accelerate the process. It was the least invasive procedure and it seemed prudent to start with it. But the IUI failed. Then the doctor said that while my ovaries seemed to be producing healthy follicles, we should check my fallopian tubes to ensure that there was no blockage. This was the first investigative procedure (called HSG). Before this, we had only done blood/urine tests and sperm tests. The HSG revealed that everything was OK with the tubes. We were told that in many cases, the HSG procedure itself clears out minor blockages and an IUI done right after that is often positive. We did our second IUI after the HSG hoping that this time it would work. But it failed once again.
I was asked to reduce weight as it aids infertility, so I started working out and watching what I ate. My husband was asked to take CoQ10 enzymes and some other supplements. We took a little break, travelled a little, cleared our heads as this whole journey was taking its toll on us.
Once we were back, we tried another IUI which failed again. At this point, we have suggested another investigative procedure called Laparoscopy Hysteroscopy, in which my entire system would be checked in detail to see what might be causing this unexplained infertility. The test did not reveal anything.
After the test, we tried our fourth IUI. This too failed. Our doctor at this point felt that we should see a specialist. We went to the resident IVF specialist in the same hospital. Under her guidance, we went through our first IVF which failed. The resident IVF doctor said that the quality of the resultant embryos was not up to the mark, which may have been the reason for the failure. Apart from the negative result, we were not happy with how this doctor spoke with us. She was rude and insensitive. We moved to a well-known doctor who also ran an IVF practice in the same hospital in addition to her private practice. We had seen her in leading women's magazines answering questions related to infertility. We decided to go and meet her. She advised that we try the last IUI under her. We did, but it failed. She then advised us that we should go in for an IVF only since we had already tried 5 IUIs. We had our first IVF under her, which failed. We were shattered.
To make matters worse, we found that the doctor completely lacked empathy. She spoke to us like a machine, very mechanically, not offering us any calming words, asking us simply to schedule our next appointment so that we can try again. We didn't know who to talk to. We didn't know any friends who were going through this process. Our parents were being as supportive as they could. They would try not to probe too much and would eagerly listen to updates we would provide them. Between the two of us, we didn't know what to do, whether we should even keep trying or let it go. After all, we had a happy and fulfilling life otherwise. I thought about this and decided that I would try whatever I can and if after exhausting all my options it didn't work, we would accept it. I didn't want to look back at 50 and feel I could have done more. I wanted 'no regrets'. We had no idea if we would succeed or fail. The only thing we could do was to give it an honest try.
We decided to change our doctor and asked around for references. We received recommendations of a doctor in Delhi who had been consulted by two family friends. Both these friends had successful conceptions and subsequent births. Full of hope, we carried our growing medical file and headed to his clinic. We found a non-standard style of operation there. Everything was forced to be in the house, everything was paid for in cash, all medicines were strictly dispensed only by the clinic which was paid for in cash and no receipts were provided for anything. We understood what was going on, but we decided to go ahead with the treatment anyhow, looking at the glowing feedback and success stories he had. He looked at all our reports and said that things looked good and we should immediately go in for an IVF procedure. Encouraged by this feedback, we started immediately. The many visits, the long waits, the medicines, the scans, the injections. We tried to keep it light as much as possible. I recall, we even went and watched Vicky donor which had got released then and had a good laugh.
This time however my ovaries that had been responding well so far started responding poorly. The follicles were not growing as expected even with high levels of FSH medications. Looking at this and at the repetitive failure coupled with a low AMH level (which shows egg reserves), we were told that my ovaries had aged prematurely. The IVF failed.
We were told that we could not conceive using my eggs as my ovaries had aged prematurely and the quality of eggs that I was producing was not good. We were suggested to go the 'donor egg' way and were asked to make an appointment for the coming month. Using a donor egg was a big decision. We were not ready to decide so quickly so we decided to take some time off.
Moreover, we found the doctor very commercially minded and we felt that he lacked empathy. We found his and his staff's behaviour very unprofessional. The atmosphere of the clinic was very factory-like and the 'only cash-no receipt' system didn't help. At this point, we began to question ourselves. How can each doctor we meet lack empathy? Were we expecting too much? Were we being too sensitive and touchy?
After a while, we began to make appointments with other doctors to get a second opinion. All the doctors would look at our reports and tell us that we should try one IVF cycle with them so that they could understand our case better. They said that each doctor has their approach and there were no rights and wrongs. Only an IVF cycle under them would reveal more clues as to why this was not working.
It was as a part of such an effort to seek a second opinion, that we reached Southend Fertility at Vasant Vihar. By now, our doc visits had become second nature. Make an appointment. Wait. Meet the doc. Explain the facts. Hope the doc would throw some light on our case. I remember our first visit to Southend IVF. Dr Sonia Malik sat in her cabin flanked by Dr Vandana Bhatia on one side and Dr Rachna on the other. They patiently poured over the several papers of all the various procedures I had undergone. I already felt a difference in their approach and their body language. But I curbed my enthusiasm, not wanting to be disappointed again.
Dr Malik looked at my HSG report from several years ago, just the way so many doctors had, till that point, but the question she asked after that was something no one had asked. She asked me if I had ever been tested for TB? I wondered what this new angle was because I didn't have TB and I was quite sure of that, after all, I was not coughing.
Dr Malik educated me about TB that affects other parts of the body and how it remains undetected. I tested positive for genital TB. I underwent TB medication for 1 year and thereafter, when the TB test still came positive, Dr Malik said that she can't continue my TB medication any longer as it might hurt my kidney and liver. She suggested we try one round of IVF. I asked her if she was sure that it would work, for which she said she wasn't sure, but given the circumstances, it seemed like the best way forward.
So in Jan 2015, we went in for an IVF-ICSI at Southend Fertility & IVF. The ovarian response was splendid. The egg quality seemed to have improved by leaps and bounds. Every egg that was retrieved fertilized into a good viable embryo. I got 4 'D5-embryos' and 3 'D3-embryos'. It was unbelievable. My previous doctor had told me that my ovaries had aged prematurely and that I should consider an egg donor, and here I was with excellent embryos. We transferred 2 of the 4, 'D5-embryos' and waited for 2 weeks.
The same 2 weeks wait that we had done several times before. This time however it ended in a positive result for the first time. We had a positive beta HCG blood test report. I had seen so many negative home pregnancy tests till then, that I bought a home pregnancy test, just to feel what a positive test looks like.
We had a healthy pregnancy and I delivered a healthy child through C section. Last year, in 2018, we decided to use the frozen embryos from 2015 and try again. By this time we had moved cities. This time, it was just about readying the body and transferring the frozen embryos. It took us about 3 months to get the hormones and other factors in order. Each month we would do the tests as recommended by Dr Vandana Bhatia, but something or the other would be off and we had to drop that cycle.
Finally, Dr Vandana suggested that we come to Delhi and we do the cycle under her guidance and direct supervision. This time everything fell into place. In Aug 2018, we transferred 2 of the frozen 'D5-embryos' and 2 weeks later, we were pregnant. I am 38 weeks pregnant as I write this and we are eager to welcome our new bundle of joy into our lives.
It has been a decade from when we started trying to conceive until the birth of our second child. We are very thankful that we found Dr Sonia Malik and her team at Southend Fertility & IVF. It was her experience and keen eye that spotted the issue while reading the same reports that a dozen doctors had gone through before. She saw what they didn't, and for that, we remain eternally thankful to her. At no point did she or Dr Vandana Bhatia give us false assurances. They always stated the risks/chances clearly at each step.
The entire team, especially Dr Vandana Bhatia and Dr Malik have been wonderful. Every nurse, every front office staff and every doctor treats you with respect. A special shout out to Divya and Devika at the front desk. The culture of a place is indeed driven from the top. Here, we felt we mattered and were not just a file no. I cannot assure you that you will conceive and have a baby if you go to Southend IVF, but I can assure you this, that you will be under the care of doctors who tell you things clearly, who don't rush you, who treat you with empathy, who help you make decisions without pushing you one way or the other and who answer all your questions without getting annoyed or losing patience. We realized after coming to Southend IVF, that our expectations of being treated with empathy, respect and privacy were not too much to expect.
Here are a few things I learnt:
We wish you all the best in your journey!