India was the craziest and most amazing place I have been. India also had the single biggest impact on my life by giving me two beautiful daughters.
We arrived in Bombay as newly-weds and working expats. We already knew that we would have to have an in-vitro conception, and before arriving in India we had visited several specialists in Poland. So we would hope to conceive by IVF while living in India – probably by return trips to Europe
Let’s Have a Baby in India
It wasn’t until we had settled in that I discovered that India is a major destination for medical tourism and IVF treatment in particular. Well, we hadn’t planned it that way, but hey why not?
Time in India flew by. Nick was busy with his work and I couldn’t find any work suitable for me. I started a hobby of photography but with time I came to the same conclusion as many expat wives. If I can’t work, and one income is more than enough to support a family, then let’s have a baby. I remember our conversation on 1 January 2009. We were enjoying palak paneer in a tiny open-air street restaurant in Bombay. The time had come.
A fortnight later we were in Rotunda clinic in Bandra. The waiting room was full of Americans and other foreigners and also a few Indian ladies. So it was true, this place on my doorstep, really is a global destination for just what I needed.
Why India is a Popular Destination for In Vitro Treatment
India is one of the few countries where Surrogacy is legal. Hence the foreign couples with Indian ladies I had seen waiting in the clinic.
Secondly, India doesn’t have the same restrictions on transferring multiple embryos as the West. This can have pluses and minuses. Transferring more embryos increases the chance of survival of at least one foetus, but it also increases the chance of multiple births and the severity of some complications.
Our First Appointment with the Bombay IVF Clinic
I didn’t have high hopes for our first visit. I thought it will be a typical first appointment – lots of talk and not much action. It was the first available date Nick could go with me, and as it happened, it was also the second day of my period. But it all played well. Menstrual blood was needed for testing https://www.rmact.com/getting-started/fertility-testing/what-is-cycle-day-3
It was all very quick, strange and fast. There wasn’t beating around the bush with “Do you really want a baby.?” “How long have you been trying?” etc.
It was, “Let’s see what we can do for you . . . and let’s do it now.”
Despite my period, I was given an internal examination and immediately I was told that there is something “wrong with me”. However the doctor tried to do the vaginal scan, she said she could not get full access, it was as if something was blocking the way.
This was a surprise, We were only here because my husband had had a vasectomy and now suddenly it was my body that was the problem? At 32 years of age, I had been examined by gynaecologists several times and had been in a number of European IVF clinics. Now in this tiny crowded clinic a long way from home in one of the dirtiest countries in the world I was puzzled and angry. If it was true, why had no-one told me about this before? Should I even believe that there was a problem now?
The doctor advised me that either I have a very bicornuate uterus or else I have a septum down the middle of an otherwise normal shaped uterus. I was given an appointment for a Hysterosalpingographic X-ray a week later.
What is a Bicornuate Uterus?
We are all familiar with the diagram of a womb looking like an upside down pear. Alternatively, it can be more heart-shaped or even more “two-horned” I understood that mine must be very malformed if it had prevented the examination.
So I researched sites such as this one: Uterus and risk of miscarriage
A septum is a less common development of the same problem, originating a generation earlier when the mother-to-be was in her own mother’s womb. The internet confirmed that the appearance of both malformations can be similar in imaging examinations. Although it is possible to go full term with a bicornuate uterus, I learnt that the chance of a late miscarriage or preterm birth are increased as the baby has less space to grow. In the case of a septum, there is an even higher chance of miscarriage such that multiple miscarriages are a symptom of women with septums.
For a few days, my concerns grew. Do I have a funny shaped uterus? Do I have a septum? Or are they just mistaken?
It turned out that Hysterosalpingography is a high contrast x-ray to look at soft tissue rather than bones. The doctor met me with the pictures and told me that it looked more look like a septum than a bicornuate uterus but the only way to check was by surgery.
I was advised that they would do a keyhole investigation through my navel. If they could confirm that it was a septum they would cut it out immediately, but if I had a bicornuate uterus then they would not be able to do anything, and because the horns were very small, I would not be able to hold a pregnancy. The bottom line was that I needed an operation.
Hysteroscopic Septum Resection
I was in a state of shock. Of course we would go for the operation, but two weeks ago I didn’t have any problems, and now I was looking at an X-ray confirming the diagnosis of some serious malformation which would give me a miscarriage if I were to get pregnant in my present condition. Suddenly I desperately wanted a baby. Previously I had hardly thought of it – I had just assumed that it would happen one day. Now I had been told that the body I have cannot carry a baby, I wanted it more than anything in the world.
A Balloon in my Womb!
The clinic in Bandra wasn’t equipped to do the operation, so they sent us to a sister clinic in Dadar – the Deccan Fertility Clinic & Keyhole Surgery Center. This was a clinic more directed to Indians than foreigners.
Checking now, both clinics seem to work under one name of Rotunda – the Center for Human reproduction.
Luckily for me, they found a septum and so after a quick procedure, I was released to go home with an inflated balloon inside me. This was to ensure that the internal wounds would heal in the appropriate shape and not grow back as a septum. It was a strange thing to have an air-inflated belly and a balloon neck in my vagina, but that was how I stayed for over a week.
Removing it was very easy. I went back to the doctor, she deflated the balloon and pulled it out. Now I would go in a course of hormones to help heal and shape my uterus. And then, at last, we could come back for IVF. No matter how I tried to distract myself with my photography and studying for my MBA exams, nothing worked. I found myself just counting the days until I could go back to the clinic.
Two months passed. As soon as I finished my tablets, Nick and I were back in the clinic at Dadar to discuss our options. It was 17 April 2009.
Our new doctor said that I could start taking hormonal injections to produce more eggs whenever my period would start. I was on the second day of my cycle. I told the doctor. It was perfect timing. She asked would I like to start that day or wait a month. We looked at each other for a moment and Nick said – “We are doing it now, yes?”
So we did. I started the course of hormonal injections and set up a daily schedule for injections and scans.
Can You Have a Baby after a Vasectomy?
Nick had had a vasectomy in April 1987, exactly 20 years earlier. We had read that an operation to reverse a vasectomy is possible, but with time it gets less feasible and 20 years was pushing it. We had already been told in Europe that our best option would be a direct sperm extraction. Now it was at last Nick’s turn to go to the doctor. In just one appointment, the doctor was able to confirm the possibility of this procedure. Nick would have sperm extracted through a hollow needle from his left testicle on the same day that my doctor would collect eggs from me.
Since they could not predict how viable Nick’s sperm would be, they advised us to consider potential sperm donors, so that the doctors would have an option on the day if Nick’s little guys were not agile enough.
Caucasian Sperm Donors in India
The doctor gave me a list of possible donors. It was in the form of two A4 sheets of descriptions of men. All the donors were from Denmark as typical North European Caucasians, and we were looking for someone like Nick. This was so peculiar – choosing a possible father based on three lines of text – 190 cm, 90 kg, blonde hair, blue eyes, 25 years old with an athletic build, postman . . . 180 cm, 85 kg ginger hair, blue eyes, 29 years old, PhD student – I really don’t remember who we chose, but knowing me, I would have been rooting for knowledge more than for looks. What I really wanted was to have a child with my husband, not a Dane, however athletic or clever.
29 April 2009 – harvest day. My overstimulated ovaries had produced 15 eggs, and Nick was surprised to discover that having a needle stuck in his testicle was not so bad an experience after all.
He waited for a while as I came round from the general anaesthetic. He remembers this scene quite vividly. The recovery room contained five places – three beds in a line on one side and two trolleys end to end along the other wall. All the beds were separated by just enough room to walk between them. This room opened from the yard outside through one grubby glass door. Nick sat outside this door with three other men in a row on an open veranda about one meter deep and five plastic chairs long. In front of him was a low wall, forming the edge of the veranda. Like millions of other walls in Bombay, it had once been white-painted cement render, but now was brownish grey and dappled with green-black fungus and red spittle stains. In front of that was a tiny yard where stray cats and birds picked over a pile of rubbish, and behind that ran an ancient iron railing with an open gate separating the clinic from the noisy dirty streets of India.
After a few hours, we went home on the bike. I would have to go back in two days to insert the fertilized eggs.
Nick took the day off, and we drove back to the clinic on our motorbike. This procedure was easy – The doctor implanted five fertilized eggs. He told me that four of them were graded as A and one as B. The rest of my eggs were frozen.
Wait, what – 5 eggs in??? Does this mean I will have quins? I was rather too confused to ask anything, the only thing I did ask was whether I could ride home on the back of the bike. The answer was no way, I must be gentle with myself to let the embryos get stuck into the wall of my uterus.
Did you notice how many times I have mentioned the word uterus? This organ was never in my consciousness, and suddenly the whole of my life had started to revolve around it. Now it had 5 little eggs to cherish.
And no, I didn’t go back home on the back of the bike, Nick rode home and I took a taxi – I had a precious cargo inside me.
Two Weeks of Waiting
I spent two weeks lying on my back taking injections, and praying that my little eggs will decide to stay put. Nick was surprised one evening when he picked up the laptop and found a google search I had made for “How to keep embryos in?”
Monsoon season was about to start, Nick was spending time mostly away from Mumbai and I was staying in, binge-watching movies, and browsing the internet for wisdom and knowledge, scared by any speck of blood I found in my undies. Then suddenly my mood lifted, and I found myself singing in the shower for the first time in my life. I thought “I must be pregnant” and then “. . . actually yes I am pregnant, five times over but am I keeping them?”
On the tenth day, I couldn’t take it any longer and snuck out to the pharmacy and bought a pee-on-a-stick pregnancy test. Nothing. Now I understand why everywhere on the internet it advises against taking these tests too early – it most probably won’t show and it only affects your mood.
However, the next time I caught myself singing under the shower I went back to the pharmacy and bought two pregnancy tests. I peed on both of them and both came up positive. Yay, what a joy!!
On day 14, I went back to the doctor and did a blood test. I was definitely pregnant. My hCG levels were 383 which is double the norm for two weeks. The doctor said it must be a multiple pregnancy if my hCG levels are so high. It was just four months after my first appointment at the clinic in Bandra
When I was around 4 weeks I had to go to Poland and I had a scan on 27 May. This is my birthday and it was also our first wedding anniversary. I learnt that I had three embryos – two single ones and one with two embryos in one sac. This one was much smaller than the others. So it was possible that I might have 4 babies?
A week later I was in the UK at a family wedding where at only 5 weeks, my belly was already bulging. We were a bit shy so early, but we told the closer family about our pregnancy.
Then just after the wedding, we went on our usual UK trips to see Nick’s family and friends. I started bleeding. I didn’t know what was happening. We went to a hospital in York, but they weren’t any help. For them, a six-week pregnancy didn’t count for much and certainly didn’t qualify for a scan. We went back to India.
Back to the IVF clinic in India
I went back to the clinic and learnt that still two embryos are growing but the third double one was not growing. I was OK with it. Two felt like a good number.
Just about that time, Nick’s company decided to close its India operations except for a skeleton staff in Delhi. Nick spent a week closing down and rationalizing staff and property resources in three cities, and then immediately he moved to Abu Dhabi. I stayed in Bombay at the start of the monsoon to finish my course of injections and to tidy up our flat for the move.
At three months we were now living in Abu Dhabi and I started bleeding again. I chose the closest hospital (Al Noor hospital in Abu Dhabi) and I went to see the doctor. Doctor Marwan Kamil became my obstetrician from that moment and a strong ally in all that was to follow. He told me that most probably the bleeding was a miscarriage of the double embryo. Otherwise, all was good. There was more bleeding for a few days, but at the same time, my two little twins were alive and growing in my belly.
Complications with the Pregnancy
In week twenty, I developed pre-eclampsia which gave me a very high blood pressure – it was reaching 180/100
By week 28, the smaller twin had almost stopped growing. At this age, growth should be 30 grams a day, and she was only putting n 30 grams a week.
Dr Marwan helped me work through all this with his calm advice and by answering our questions. He also told us that as Al Noor was a private Hospital, they were not allowed to deliver before the 35th week. I had to register with a government hospital in case of early delivery, but inside I was desperate to stay under his wise supervision if such was possible.
Owing to pelvic damage after a car accident in my early twenties, I already knew that I would have to give birth by C-section.
So I hung on until week 35 as my blood pressure continued to soar as high as 220/120. Then coincidentally my waters broke as I was already on the trolley for the Caesarian.
Tania was delivered at 1.375 kilos and Zoe at 2.1 kilos. If we had ever wondered whether the girls came from Nick or a bottled Dane – all was now clear. From day one it was clear that Tania had inherited Nick’s mother’s nose while Zoe had Nick’s father’s nose – poor kids!
As I write this, it is exactly 10 years since I conceived. My little girls grow lovelier every day. Tania is still smaller than Zoe. Four years ago we decided to slow down with our professional life and start travelling. Last year we went to Abu Dhabi and introduced the girls to Dr Marwan. We haven’t yet taken them to India, but we will soon.
Postscript: Other India IVF Success Stories
When we were living in Dubai I met other people who had received IVF treatment in India. One of them had an IVF pregnancy with triplets, the other one had triplets born on two different days from three different mothers. How did that happen? To double their chances for surrogacy the second time they tried it, they had worked with two mothers and both of them got pregnant and carried the babies. One of the surrogate mothers delivered twins!
This article is a true story of our own experience. We are not experts in any medical discipline, nor do we claim any special knowledge or expertise, and we are not consultants for our readers.
Please check anything critical with your own medical advisors when developing your own plans.