Age said WAIT, History said YES

By Dr. Avanthi Vellala

She was 21. Married at 16, trying since the day they got married. Five years of trying. Five years of hoping. By the time she walked into my clinic, she was 21 years and 3 months old.

I want to pause on that for a moment. There is an age limit in ART treatment in India. She was just over it when she came to me. A few months earlier and things might have looked different. I don’t know if any of her previous doctors had explained that to her.

She had severe PCOS with hyperadrogenism. Irregular cycles. Multiple cycles of ovulation induction with timed intercourse at multiple clinics across the years. A lot of money spent. Nothing to show for it.

When they came to me, the first thing they said was: no doctor ever took the time to explain what was happening. They had asked questions and nobody answered. Not properly. Not patiently. They had been left to figure it out alone, visit after visit, year after year.

They were tired. Not just physically. Tired in that deeper way after years of hoping for a conception.

Her husband is a civil engineer works in construction, based in Hyderabad for work, keeps him occupied. His semen parameters had a teratozoospermia component but nothing significant enough to change the plan. They came from a village and finances had always been tight. What they had spent across multiple clinics without answers weighed on them.

Given her age, I suggested IUI first. She’s young there is no reason for not to do IUI.

But given the number of failed ovulation induction cycles behind her over years at different clinics, IVF was a reasonable next step too.They enquired about IVF.Then I explained them both. The success rates, the risks, the costs.

He thought about it. And he chose IVF.

Her response was excellent. 20 eggs retrieved, 13 mature, 13 fertilised, 10 blastocysts. We froze the six best.

Every visit, her mother-in-law came with her. A warm, quiet woman. I’m not sure how much of the clinical conversation she followed the terminology, the numbers, the protocols. But she sat through every appointment with a gentle smile. And every time she left my consultation room, she waved goodbye.

Every single time. That little wave.

She didn’t need to understand the protocols. She understood that her daughter-in-law was being cared for. That someone was giving them time. That was enough for her.

We did a frozen embryo transfer with two embryos.

Positive. Singleton.

I was relieved. Not just happy. Relieved. Because this is a simple, sweet family who had already been through so much without ever truly understanding why. Explaining a failure to them would have been one of the harder conversations I’d have had to have.

The heartbeat scan fetal heart rate present, strong. Yesterday she was 9 weeks and 5 days. Everything looked good. Her husband took leave from work and came in for the scan. Both of them sat with me for a long time after. I kept listening.

Something he said stayed with me.

He spoke about his faith they are deeply religious, strong believers in prayer. But what struck me was how he framed it. He didn’t say that prayer was the answer. He said that prayer and medical treatment go together. That you have to do your part the right doctors, the right treatment, the right time and you believe in God alongside all of it. Not instead of it.

He even mentioned that his brother’s daughter has a serious health condition that is affecting her quality of life. He told his brother go to the right doctors. Seek the right help. And yes, pray. But don’t do one without the other.

They came from a remote village. Life hasn’t been easy for them. But this man’s understanding that faith and medicine are not in opposition, that you bring both to a difficult situation and give each its proper place, that was a clarity I wasn’t expecting. And it moved me.

What this couple needed, more than anything, was someone to sit down and hear to them. Not a better protocol. Not a more expensive clinic. Just someone who would answer their questions. Look them in the eye. Tell them what was happening and why.

That is not a high bar. It should not be a rare thing. I am happy that they felt cared for here with me

I am wishing them a safe and smooth pregnancy. And I hope the next time I see them, it’s with a baby in their arms and that same warm wave from her mother-in-law.