You are not alone
Not Just You
By Dr. Avanthi Vellala · Fertility Specialist
Not just you. How does it look when the whole clinic is waiting for your beta HCG report, and when the whole clinic celebrates alongside you?
Most of the time, patients don’t know that we pray alongside them. I especially can’t sleep the night before a UPT. Sharp 9am, I call the team and ask what the result is. Those two pink lines. I celebrate them. The sigh of relief I feel after seeing them. The silly sentiments I carry after doing the best I can.
To name one, I see my husband’s face every morning especially on the day a repeated failure patient has her UPT. This time, my husband and I had a fight and hadn’t completely reconciled yet. But still, I thought let me see his face, let me try and see.
Why am I telling you all this before even getting into the case?
I did a lot of negative counselling with this patient. I didn’t give her much hope. I only said I am trying with whatever we have. The embryo itself is not great. I generally don’t write anything before a heartbeat, but this one is worth celebrating early.
I KNOW IT’S EARLY.
But not just me my entire staff is happy today. Sometimes I feel grateful to have a team that shares the same brain cells.
Let me get into the case.
This patient came to me first in June 2025. She was 33, her husband 37. Married 8.5 years. Primary infertility. One failed IUI. She had decreased ovarian reserve, and he had OATZ. Follicle count of 1 and 3. We also found a polyp in the cavity.
The plan was IVF, with polypectomy before the transfer.
We started.
1st cycle OPU done on 5/7/2025. 5 expected, 4 retrieved, 2 mature. One D5 GR2 2BC frozen.
2nd cycle, a pooling cycle to build up embryos. OPU on 29/9/2025. 3 expected, 2 retrieved, 2 mature. One D6 GR3 3CC frozen.
Hysteroscopy and polypectomy done in October 2025. Then we planned the FET.
She was a case of thin endometrium. That month, her lining grew slowly despite everything oral, transdermal, vaginal, uterine flushes. We did a single embryo transfer. GR2 2BC.
Biochemical pregnancy. Beta HCG 47.3 mIU/mL.
We sat down and spoke about it in detail embryo abnormalities, endometrial receptivity, autoimmune factors. But the real challenge was simpler and harder to say creating embryos at all.
I told them we have only one GR3 left and the success rate with it would be low.
One day she came back and said she wanted to go ahead with another retrieval. But she was scared. Every time she went under anaesthesia, she feared she might not come out of it. I reassured her, told her our anaesthetist would take good care of her and that we have a good team.
This girl is extremely outspoken. You know that kind of person speaks their mind, won’t keep anything in their heart. I need to mention that we are completely comfortable with each other (alteast that’s how I feel it).
Her husband came along to that conversation. He noticed the BTS standees on my table.
(Okay, it’s out of context. But how can I not mention it. It’s BTS.)
We agreed on another cycle. I helped as much as I could.
Same story. OPU on 2/7/2026. 3 expected, 4 retrieved, 2 mature, 2 fertilised. One early blast on D5, slow expanding.
I wasn’t there for the D5 discussion. My junior colleague, depending on how the early blast looked, counselled her that it was very poor quality and there was a high chance of NO BLAST
The patient felt sad. She wanted to speak to me but I was in London for a conference and couldn’t connect with her.
We froze one 2CC GR3 on D6.
After I was back, I called and told her we had frozen one embryo poor quality. She took it in.
She wanted some time before the next transfer. She had changed jobs, a demanding project, stress. She has recurrent cyst forming tendency.
When she returned to start the FET.D4 of cycle, all clear. She spoke to her manager, got leave approved. We started.
Natural cycle FET. On her first scan back, the progesterone came out at 1.1. Her endometrium was beautiful triple line, already 8 to 8.5mm.
Last cycle we struggled so hard to build that lining. I was so happy seeing it this time. I didn’t want to waste the cycle. I started progesterone support and did the FET which fell on a Sunday.
I gave her all the supportive medication, explained everything, and told her clearly the main issue is embryo quality. She shouldn’t be disappointed whatever the result. We are trying our best.
So finally today is that Sunday. The day of her UPT.
Two pink lines.
I was extremely happy.
I was waiting for the beta HCG report and I couldn’t hold it. I posted a poll in our group whoever guesses the value closest gets treated to pizza tomorrow.
My nursing team and PRE chose 450. I chose 384. My junior embryologist chose 700. I was happy for his optimism. I thanked him.
The result is in now. Whoever is reading this guess the value and post it in the comments. Clue - the nursing team won.
This lit up my Sunday.
To this extremely cheerful and optimistic patient who took every injection, every pill, multiple procedures all of it with grace. Girl you slayed and
Please know that me and my team worked alongside you, we waited alongside you, and we are celebrating alongside you.
I am extremely happy for you. I will keep you in my prayers.
Thank you for choosing me. Wishing you all the best. Hope you deliver safe and sound. 💛
Guess the beta HCG in the comments 👇
Dr. Avanthi Vellala · Fertility Specialist · Oasis Fertility, Gachibowli, Hyderabad