The Church Across the Road...

By Dr. Avanthi Vellala

I didn’t plan this blog as a series. It became one on its own.

Right across from my clinic, there is a church. Every Sunday, people gather there. And somewhere between the prayers and the conversations that happen after in that quiet, trusted space between people who know each other my name came up. More than once.

One patient told her church mates. They came to me. They conceived. And then they told others. Five patients in a row, all connected through the same Sunday gathering, all carrying their own version of the same quiet hope.

I’ve thought about that a lot. What it means when someone trusts you enough to give your name to a friend who is struggling. That’s not a Google review. That’s something much more personal.

Here are their stories.

The One Who Started It All

She was 35. Five years of marriage. AMH of 0.7 low, but not hopeless. Behind her already were five failed OI cycles and one failed IUI.

We went to IVF. Nine eggs retrieved, nine mature, seven fertilised, three frozen blastocysts. Before the transfer, we found a large polyp 1.5X1.5 centimetres. We did the hysteroscopy, removed it, and then transferred two embryos.

She conceived on the first go.

I don’t remember the deeper conversations we had during her treatment. But I remember her well. And I remember what she did after. She quietly told her friends about me. That’s where this story really begins.

Thin Lining, Twin Heartbeats

She was 32. Five and a half years of marriage. Primary infertility. Mild PCOS, severe endometriosis, LUF tendency (the grown follicle doesn’t rupture but remains as a cyst), a thin endometrium, one failed IUI, and male factor on his side asthenoteratozoospermia.

The embryo formation went beautifully. 26 retrieved, 23 mature, 22 fertilised, 12 blastocysts, 7 of the best frozen.

Then came the real challenge. Her endometrium.

Thin Endometrium is one of those problems that sits between you and a result NO matter how good the embryos are. We did a hysteroscopy, followed by endometrial PRP, a procedure using the patient’s own platelets to stimulate endometrial growth. Then we planned a Frozen embryo transfer cycle, extending the cycle to give her lining every possible chance.

We transferred two. She conceived with twins. She should be around 28 weeks now.

Trusting the Judgement

She was 34. Eight years of marriage. Secondary infertility, her first pregnancy hadn’t had a heartbeat. Decreased ovarian reserve with an AMH of 0.8 for almost a year by the time she found her way to me.

We tried two IUIs first. Both failed. We moved to IVF.

It wasn’t easy for them to make a decision about IVF as they were keen on IUI or natural conception from the beginning

Finally they made their choice.

We expected 8 eggs, retrieved 11, 8 mature, 6 fertilised, 5 frozen. One of the best was biopsied for genetic testing. It came back euploid. We did a hysteroscopy, cleared a small polyp.

Then the waiting began. FET was postponed twice once for a cyst, once for mid-cycle spotting. Every postponement adds to the weight a patient carries.

When we finally got to the transfer cycle, building the lining wasn’t straightforward. But something told me to go ahead. I trusted my judgement. We transferred the genetically normal embryo.

She was positive. Referred at 11 weeks.

One More Try

She was 30. Five years of marriage. Primary infertility. Two failed OI cycles, one failed IUI. On his side OATZ (low sperm count, low motility and poor shape of the sperm) along with varicocele.

He underwent varicocele ligation surgery . The parameters were still low. The couple wanted to try one more IUI. I explained the odds honestly. They wanted to try anyway.

It failed. We moved to IVF.

10 expected, 15 collected, 14 mature, 12 fertilised, 4 blastocysts formed. We transferred the best two.

She conceived with a good beta HCG value. Hear beat is scan due.

420 Kilometres of Hope

This one isn’t technically a church mate. she was referred by the patient’s brother in law in Case 2. But she came from 420 kilometres away. Just to see me.

She was 24. Five years of marriage. PCOS with irregular cycles. A history of laparoscopic PCOD drilling. Multiple failed OI cycles and a failed IUI.

When someone travels that far on a word of mouth recommendation, you feel the weight of it. The pressure to deliver for someone who has placed that much faith in you sits differently.

I explained the success rates. I told them what PCOS can sometimes do. Give you Empty follicles with NO eggs inside them and poor quality eggs . I always tell patients this because I’d rather they go in with clear eyes than be blindsided later.

19 eggs collected, 17 mature, 15 fertilised, 5 embryos frozen. We planned a natural cycle FET and transferred two.

On transfer day, her family sat with me and said, don’t say it might not work, we want it to be positive.

I said of course I want that too. But it’s my responsibility to prepare you, not just reassure you.

They asked what happens if it fails. I said, let’s wait for the result first.

She conceived with twins on the first go.

Then one day she called from back home. Bleeding. She had gone to a local hospital. The doctor there spoke to me over the phone and said only a sac was visible. I asked about fetal pole. She said NO fetal pole.

My heart dropped. By that point there should have been heartbeats. I thought of her family’s faces on transfer day. The 420 kilometres they’d travelled. The hope they’d carried all that way.

I needed to see it myself. Once the bleeding settled, I asked them to come back down.

They did. And on the scan I could see Two fetal poles. Two heartbeats.

I exhaled.

Five cases. Five different challenges. Thin lining, low reserve, severe endometriosis, OATZ, PCOS, DNA fragmentation,Varicocele, polyps, postponements, a phone call that scared me from 420 kilometres away.

Every single one came to me because someone sat in a church on a Sunday and said GO SEE HER