Second Chance

By Dr. Avanthi Vellala

She was 30. Six years of marriage. AMH of 0.1. Follicle count of 1/2, multiple failed OI cycles, three failed IUIs

When I saw those numbers, I knew what I had to say. And I said it. I recommended donor egg. I explained the success rates. I was honest, the way you have to be honest when someone is sitting across from you with hope in their eyes and the biology is working against them.

They listened. They nodded. And then they went quiet.

They weren't ready. I could see it. They weren't saying NO to me, they were saying not yet to the idea of letting go. I didn't push. There's a line between being honest with someone and taking away the last thing they're holding onto. I didn't want to cross it.

They disappeared for a year.

And then they came back. Walked in and said, we want to try with our own eggs.

We started the IVF cycle. Stimulation went as expected. I was hoping for two eggs, we got two. Both mature. ICSI done.

Zero fertilisation.

I sat with them and told them. Total fertilisation failure. And then, gently, I asked again,

Are you open to donor?

They looked at each other. And said, we want to try again. With our own.

This couple barely spoke. They never had much to say in the clinic. No big questions, no long discussions. But you didn't need words. You could see it in their eyes. They knew the odds. They understood what I was telling them. And they still wanted to try.

That kind of quiet determination does something to you as a doctor. It gives you confidence and it terrifies you at the same time. Because now you badly want to give them the result. Not just do your job. Actually give them this.

I changed everything. New protocol. Different injections. I told them clearly, we will only proceed with retrieval if the response is good. No point pushing a cycle that won't give us what we need.

I was expecting four eggs. We got five. Four were mature. Three fertilised. Two made it to blastocyst.

When I told them, her husband looked up at me and I saw his eyes fill.

“Thank you. This is the best news I’ve heard in a long time.”

I don't know why it hits differently when men get emotional. Maybe because they spend so much of this journey holding it together for their wives. Maybe because we rarely ask how they're doing. But when it comes it weighs on you. In the best way.

We did a hysteroscopy before the transfer just to make sure the cavity was right. Then planned a natural cycle Frozen Single embryo transfer.

I discussed the option of transferring two. They looked at me and said we trust your judgement.

That kind of trust is something I never take lightly.

Beta HCG came back at 1315. Clinical pregnancy confirmed. Heartbeat on scan.

Six years. Failed OI cycles. Three failed IUIs. A year in between where they just sat with it all. Zero fertilisation on the first IVF.

And two blastocysts that came from her own eggs. Everyone, including me, wasn’t sure WE could get there.

Note to this couple : Please come back with a baby as grounded as you. I’m sure you are going to raise him/her to be THE BEST.