The miracle baby story: Born after 10 IVF cycles, his mother never gave up despite her pain and lows
The miracle baby story: Born after 10 IVF cycles, his mother never gave up despite her pain and lows
Nilamben didn’t know she had underlying TB that blocked conception. It took 17 years of pain and missed chances for her to become pregnant.
‘Medical literature everywhere indicates there are no significant side effects up to 10 IVF cycles unless someone is allergic, or has an adverse response to a drug,” says infertility expert Dr Nayana Patel.
Nilamben and Manjibhai with their son
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Almost on a reflex, Nilamben (45) and Manjibhai (55) Chauhan look away from us the moment their seven-year-old son climbs the window grills, rappels down, wears roller skates and whizzes around the house. You could judge them for being helicopter parents but he is the only prayer that has been answered in their ordinary life, tucked away in the quiet town of Tarapur in Gujarat’s Anand district. It takes more than just fortitude to go through cycles of in-vitro fertilisation (IVF). Nilamben conceived on her 10th cycle after trying for 17 years and battling an underlying tuberculosis (TB) that ate into her uterus. Mentally, she was pilloried and taunted by her family as a “woman who was not born to be a mother.” So her son is an answer to their many questions and the reason why she can still bear the severe pain on her right arm, the result of multiple fertility injections.
Manjibhai, an English teacher for senior secondary students at a charitable trust-run school, and Nilamben, married in 1991. “When natural conception failed, we started approaching fertility experts in Ahmedabad sometime in 1999. One of the clinics told us that my wife could be suffering from TB but it was never detected, so we never quite knew why the cycles failed,” he says. It was not until 2010, when the couple met Dr Nayana Patel, infertility expert at Akanksha Infertility and IVF Clinic, that her TB was diagnosed. Dr Patel is now medical director at her facility, Akanksha Hospital and Research Institute, in Anand. After several unsuccessful cycles with Dr Patel, Nilamben conceived twins on her ninth cycle in 2015. But she miscarried in the fourth month of her pregnancy. Then in the 10th cycle, she carried the baby to term.
Says Dr Patel, “She is the perfect example of a positive attitude and persistence that paid off in the end. She was never disheartened although she had subclinical TB, which complicated her embryo implantation. Such TB means that she had come in contact with a TB patient in her early years. This causes infertility, thinning out the endometrium. Her previous cycles had failed because her uterine lining was not strong enough to hold the implanted embryo. TB can also block fallopian tubes and reduce the ovarian reserve of eggs. Overall, the success rate of IVF in patients with TB is quite low. My suggestion is to do rigorous checks for TB, subclinical TB in particular, for women as part of their pre-pregnancy check-up so that we can reduce infertility.”
Dr Patel says usually the chances of implantation increase after six or more cycles though Nilamben’s case is rare as she persisted for as many as 10 cycles. “But she’s not an exception. I have had a patient who conceived at the 15th cycle. With a ban on surrogacy in India, women may opt for more cycles. Apart from the physical and emotional burden, the economic burden could be worrisome as infertility treatment remains outside insurance coverage. Each cycle can cost between Rs 1 and 2 lakh. While most insurance companies in India do not cover infertility treatments, some include infertility and IVF treatment as a ground for availing personal loans. As for the safety of the procedure, medical literature everywhere indicates there are no significant side effects up to 10 IVF cycles unless someone is allergic, or has an adverse response to a drug,” she adds.
What should women do to prepare themselves for fertility procedures like IVF? Dr Patel suggests diet, exercise and lifestyle correction for both partners to improve the quality of their semen and eggs. “The greatest barrier is lack of awareness about fertility options and the quality of the IVF clinic and laboratory. Remember IVF is a customised process and the right lab should be able to analyse your medical condition and calibrate your treatment. Women in villages end up wasting a lot of time on alternative medicine and rituals. We must convince them that medical intervention is not against religion or custom. Early diagnosis is the key to having a successful conception,” she says. “Malnutrition, TB and sexually transmitted diseases can affect fertility. Excessive social pressure on the woman causes a lot of anxiety. Most of my patients have high levels of epinephrine when they sign in. And stress — social, psychological or physiological — is the greatest enemy of fertility,” she adds.
Perhaps, that’s one of the reasons why post-COVID, Dr Patel is seeing more couples seeking assisted reproductive therapies. “The semen counts are going down in men while women are reporting lower ovarian reserves. Though there is no scientific study to establish the correlation yet and research is ongoing, we should look at the mental health graph as a trigger,” says Dr Patel.
Nilamben and Manjibhai had their lows. So disheartened were they that the couple took a break briefly between 2000 and 2005, and at some point, even considered the possibility of Manjibhai remarrying. “There was continuous pressure from my family and our community. Nilamben was treated like an outcast, excluded from all celebrations. So every time the pregnancy report came back negative after a cycle, both of us would hold each other and cry. I slid into deep depression myself and had to take medication,” says Manji
Though benumbed, Nilamben didn’t fight shy of seeking options. “People suggested adoption from within the family but that would put us in conflict with the biological family. That’s why I chose IVF. There was the pain from injections and the inflammation from ovarian stimulation. And then there were the highs of expectancy and the lows of disappointment. I became a wreck,” she recalls. Not to mention their medical expenses. “We spent around Rs 12 lakh on IVF cycles over the years. All my salary would be spent on this. I took loans from our teachers’ cooperative and borrowed from friends,” adds Manjibhai.
In 2005, the couple resumed their IVF treatment but it was not until 2010, when they met Dr Patel that they found hope. She attempted several workarounds to implant the embryos but the obstacles were far too many. Dr Patel treated the TB first and then did laparoscopy and hysteroscopy to assess Nilamben’s uterine health and abnormality. Given the poor condition of her uterus, she even suggested surrogacy but they wanted, in Nilamben’s words, “their own flesh and blood.” After several unsuccessful cycles with Dr Patel, Nilamben conceived twins on her ninth cycle in 2015. But she miscarried in the fourth month of her pregnancy.
Both Dr Patel and Nilamben waited with bated breath when the latter got pregnant in her 10th cycle. But in the 16th week of her pregnancy, Nilamben developed a huge swelling on her left leg. It turned out to be deep vein thrombosis (blood clot in one of the deeper veins of the body), something that’s left her limping to this day. “We put a stent to divert the blood flow, which was removed post-pregnancy. Nilamben was on blood thinners and given her high risk, practically stayed in the hospital throughout her pregnancy. We decided to do a Caesarean birth and the only hospital with ICU and facilities for a delicate case such as this was the Shree Krishna Hospital in Karamsad, nearly 30 km from where the Chauhans live,” says Dr Patel.
The baby weighed around two kilograms at birth. This meant a few more weeks of worry for the parents as the newborn was kept under observation in NICU. However, once the risk period was over, they took their child home. The family celebrated the moment with a community feast and distributing silver coins. “These didn’t matter to me at all. What mattered was the validation I got as a woman,” says Nilamben.
Looking back, what would Nilamben have done if her 10th cycle had failed. “I would not have been defeated but gone for another cycle, only to understand the limits of possibility,” she says, her eyes fixed on her son.TIE
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