When Alice and Alex started trying for a baby naturally in May 2017; they had no anticipation of challenges. Following their marriage a month earlier, they settled down in one of the large cities in the southern part of the country as they looked forward to starting their family.
But month after month, their expectations were not met, and Alice still wasn’t getting pregnant. After almost two years of waiting, they consulted medical doctors, who carried out tests and examinations and unanimously referred them to specialists for further investigations.
A few months later, Alice, aged 33 at that time, had a history of irregular menstrual cycles. She and Alex, who was three years older, were seen and counseled by a fertility specialist who diagnosed her with Polycystic Ovary Syndrome.
Narrating their history, they related to the specialist about how they had tried for years for a baby without success. The reproductive endocrinologist did more tests after the diagnosis and after counseling recommended Assisted Reproduction Technique.
They settled for IVF but were not rewarded with a pregnancy. After a few more failed cycles and more tests, they changed their fertility clinic and consulted a highly recommended reproductive endocrinologist in another state.
The new fertility specialist was more thorough. She insisted that they repeat all the previous tests, and new investigations were carried out; their diet, lifestyle, and history were scrutinised with a toothcomb. When his history was taken, Alex recalled a hernia surgery he had more than two decades previously. Eventually, he was diagnosed with male factor infertility.
The couple now realised that their chances of conceiving naturally were lower than average. Following a series of investigations, they commenced a new series of IVF cycles combined with Intracytoplasmic Sperm Injection – which came recommended as the most effective method for tackling male and female factor infertility in the same couple.
Alex and Alice learned that ICSI is a procedure in which eggs are fertilised in the laboratory by an embryologist, who injects a single sperm into an egg using a tiny needle called a micropipette.
The procedure commenced with the specialist administering a combination of high-dose drugs to help stimulate Alice’s ovulation. The egg retrieval process went smoothly and 16 eggs were harvested. Ten of the eggs were fertilized via the ICSI process. On completion of the fertilisation process, eight embryos were produced and there was so much optimism for successful transfer.
But just before the embryo implantation, Alice and her husband were informed by their fertility care team to consider Preimplantation Genetic Testing for aneuploidies (genetic abnormalities). They gathered that because of their previous pregnancy losses, there were strong grounds for them to opt for the test.
The couple was told that PGT is an early form of prenatal genetic diagnosis where abnormal embryos are identified, and only genetically normal embryos are replaced for implantation. Although they did not hesitate to consider the test, the cost was initially inhibiting.
Paying for their first-ever round of IVF with ICSI was done out of pocket, so it was quite a cause for concern factoring in the cost of the PGT procedure. But in the end, when they considered the benefits of PGT in providing the right knowledge that enabled them to make the right decision, it won the day. They decided to go through with the procedure so as to select the eight embryos.
Alice recalled that their expectation was to have the best chance possible and to avoid transferring embryos that could potentially lead to another failed pregnancy, miscarriage, or severe birth defects. The eight embryos were biopsied.
When the PGT results came back, four of the embryos were aneuploid (abnormal), and three others were not fully dividing and so were not recommended for transfer due to the chromosomes that were affected.
Just one of the embryos was normal and it was transferred during the same week. Alice pinned all her hopes on that single, healthy embryo. She prayed and fasted that it would implant. Her prayers were answered.
About two weeks later, she went for the pregnancy test; she held her breath as the nurse read out the result. It was positive; she was pregnant.
Alice had an uneventful pregnancy and their first daughter, Rachael, was born nine months later. When she looks back at their IVF decisions, Alice always expresses her joy in choosing to pursue PGT.
Although young with no serious or obvious medical issues in their families, the suggestion of PGT by the reproductive endocrinologists and their decision to go through with it, was their window into the world of parenthood.
Alice and Alex are hoping to build their family soon with a second child, and if they opt to go through IVF again, they won’t hesitate to have their embryos tested, just like the first time.
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