Is the Fertility Journey the Same for Everyone?

By Dr. Avanthi Vellala

No. It isn’t. And I don’t think I need to dress that up.

She was 39. Two years of marriage. AMH of 1.2 ng/ml. Male factor of astheno teratozoospermia on his side. We planned IVF with PGT. She said YES lets do it. No hesitation. She had clearly already done her research, processed her options, and made her decision. I respected that.

We retrieved 4 eggs. All 4 matured. All 4 fertilised. Three made it to blastocyst. Two were good enough to biopsy. Both came back euploid.

Two normal embryos. That’s a good place to be.

We found a polyp in 1st visit. She did Hysteroscopy +polypectomy outside and then came back for IVF. We planned her FET. Two months later — it was back. Another hysteroscopy. Another polypectomy. More waiting.

She took it in stride.

We finally did the HRT FET (frozen embryo transfer) One euploid embryo transferred.

I wasn’t there for the transfer.

I’m not going to make excuses for it. Something came up and I couldn’t make it.

She called afterward and said — how could Avanthi ma’am not come? She knows my case. I was expecting her.

That stayed with me.

The result came back negative.

She came in for counselling and looked me straight in the eye.

“My transfer failed. I’m not sure if you being there would have made a difference to the result. But it would have made a difference to me.”

I didn’t have anything to say to that. Because she was right.

Some patients are blunt. And the blunt ones, I’ve realised, are often the ones who trust you the most. She wasn’t attacking me. She was telling me what she needed. That takes something.

Something hadn’t been right in her first cycle. I did an ERA — mapped her exact implantation window. We planned the second FET around her receptivity, added strong luteal phase support, timed everything precisely.

She conceived.

I remember the relief I felt. Everything looked good. I referred her at 11 weeks. She was happy. She was finally on the other side.

NT scan normal. Double marker low risk. Early TIFFA normal.

Then one day she didn’t feel right.

She went to her gynaecologist. And she heard the words no one should ever have to hear — IUFD. Intrauterine foetal demise. At 18 weeks.

Gone.

I don’t have the words for what that kind of loss feels like. I’m not sure anyone does.

She called me the next day.

“I’ll come back to you. I want to freeze embryos again. I’m not sure if I can form good ones this time — but I want to try.”

The day after losing a baby at 18 weeks. She called to say she’d come back.

Her courage to try again. I feel lucky to be chosen.