TALE OF A LOST WOMB

(The Indian IVF Market and A Woman’s Trauma of Failed IVFs)

The doctor’s chamber was like a harbinger of hope, the procedural room felt like heaven. For Rupsha, they bore the seeds of a dream, the need for a child in her otherwise happily married life. The pulse of motherhood that rips off a woman’s heart in the midst of anything negative, that drives women on an instinct that’s as raw and primitive as sex, can at times be twisted by the hands of failure. Every dream and every need might not always come true.

Spikes of haplessness and hopelessness strike when the womb fails to deliver what it’s supposed to deliver. When hormones play wrong and when a lively embryo formed by the union of a sperm and an ovum fails to bloom. The womb produces hormones that force it to miscarry or the sperms turn antagonistic to the ovum ensuring the production of a non-viable zygote that cannot and will not flower out into a much-awaited baby.

But Rupsha’s husband needed an heir and she too needed the taste of motherhood. Her husband was ready to spend lakhs of rupees but he had to have someone of his own flesh and blood to gift to his parents. He was their only son and any failure to produce a baby would be like missing the link of heredity. Adoption won’t do. For that meant not his genes to boast of. He convinced Rupsha that in-vitro fertilisation is the last word and he was confident that medical science was well equipped to fill in their void.

However, Rupsha had heard from one of her colleagues that chances of having a biological child after 40 with her own eggs through IVF and carrying that child to maturity would be rather difficult and the hormonal treatment she has to undergo in the process might have long-term impact on her health. Even the viability of ova after the age of 35 for a woman is doubted. Chances thus fall. But Rupsha was unperturbed, she was ready to allow doctors to experiment with her body, she had to succeed. It was like winning a war for her. 

And well, doctors at the infertility clinic did give her immense hope. They made the whole thing sound like creating a Christmas doll in the factory. They cited examples of women above 40 having IVF babies and how easy the whole procedure was, promising her a 50-50 chance, and so on and so forth. She plunged. Taking hormone injections at regular intervals to prepare her womb for the much-awaited child that nature had refused her was like conquering the fear of the unknown. And she had conquered the fear of pain, the fear of subjecting herself to shots, medicines and repeated hormone therapies. Her child would be born in a laboratory with her own egg and her husband’s sperms. The dream of this union kept her going.

Every procedure ran into tens of thousands, every time the light of hope kindled, doctors assuring the embryos were of very good grade, tested in the laboratory, would surely produce healthy babies. Yet, the cruel hands of destiny triumphed over human knowledge and expertise. Rupsha conceived but every two months later she miscarried as well.

Every month she got a daily dose of injection to suppress her natural menstrual cycle. Then she was given FSH (Follicle Stimulating Hormone) injections for 12 days to increase the number of eggs she produced per cycle, to increase chances of getting more and more embryos. Then again 34 hours before the eggs were collected she got another shot to help the eggs mature. Egg collection at times led to cramping and vaginal bleeding. But she just ignored. She was on her mission to produce a new life. She cried at times alone when none could see her, in fear of another miscarriage and the pain of repeated shots. On days of embryo transfer she would be given more injections to prepare her womb for the transfer. She feared she might get ovarian hyper stimulation syndrome (occurring in almost 10 per cent of IVF cases due to the fertility drugs) or even end up with ectopic pregnancy (where the embryo grows outside the uterus usually in the fallopian tube), but the experiments continued.

And every time it failed, Rupsha’s husband looked so angry and frustrated, like a wounded animal ready to strike back. Rupsha recoiled at his anger, was it her fault that she couldn’t hold the baby? Every time she stepped into her house, her in-laws would sigh at the prospect of losing another baby, reminding her if they had a grandchild the house would have turned so joyous. But hadn’t the IVF clinic promised them that their success rates were so high that some patients who had failed IVF cycles elsewhere were even offered a guaranteed pregnancy program?

And after two failed cycles even the doctors turned aggressive trying to assert that their work of producing beautiful embryos was done. Rupsha was a patient of implantation failure, a tag that refers to patients who have undergone many IVF cycles, produced viable embryos, yet the embryos consistently failed to implant for unexplained reasons. Tagged and branded she was like a piece of paper thrown into a waste paper basket. Even her husband who was so confident and ready to spend lakhs started complaining how his hard-earned money was flowing down the drain. Rupsha’s sense of failure was so overwhelming that she even had nightmares of her bleeding and losing the foetus amidst a stack of thousand rupee notes popping out of her husband’s wallet!

To add insult to the injury the doctors and her husband suggested of taking a donor’s eggs as after two cycle failures it seemed the doctors finally realised her eggs might not be healthy enough. Her child would not look like her, her husband persuaded it will have his genes, wasn’t that enough? Then why not adopt, was Rupsha’s query? But her husband was adamant, he needed his own baby.

They saved up another lakh to pay the egg donor and go through another IVF cycle. The donor was 25, was brilliant according to the needs and went by the medical textbook details, but this time round Rupsha got a call from her clinic after a few weeks stating her pregnancy test after 3 weeks of implantation showed weakly positive. That meant it might not be viable at all. She had a scan done and the doctors dramatically presented the death of a tiny foetus that just grew up to two units though it was supposed to have grown four times. They charted the possible reasons of such a phenomenon in their own medical terms. For Rupsha it was like witnessing the slow death of a life. She walked out of the clinic silently, no tears, her husband was not there to console her, he was off to a meeting as he had already heard the hopeless case from his doctor in the morning. Why didn’t anyone put a hand on her shoulder and say it was really an awful thing for her to go through all this? 
For Rupsha's family, infertility was shrouded in shame as she kept on losing her babies, she felt she was undergoing a silent reproductive death. She had indeed turned a victim of the IVF global market. She was their experimental specimen, a product who could not be packaged and sold.   

 HARD TRUTHS ABOUT IVF FAILURE

• Female age, embryo quality, ovarian response, and implantation issues.

• Some infertile patients undergo many IVF cycles and produce embryos, but the embryos consistently fail to implant for unexplained reasons.

• Another group of patients who often do poorly in other IVF clinics are those who have PCOD (Polycystic Ovary). Because many doctors are so worried about the danger of OHSS ( ovarian hyperstimulation) in these patients, they often end up superovulating these patients badly, and retrieve few poor quality eggs, compromising the pregnancy rate.
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• A look at the data shows in Europe 77% of treatments fail. The Centre for Disease Control has it at 70% failure. It’s amazing that five million babies have been born out of IVF but there are least 10-15 million couples whose treatments have failed.