Tag: High risk infertility case management India healthcare

Dr. Alimileti Jhansi Rani, Consultant and Centre Head, Birla Fertility and IVF Hyderabad, explains how reassessment and embryo donation helped overcome long standing infertility in a high risk case

Birla Fertility and IVF Hyderabad recently treated a couple whose infertility journey spanned 15 years and multiple unsuccessful treatment cycles across countries. When they arrived at the centre, the 43 year old woman and her 45 year old husband had already undergone five failed IVF cycles, four in Australia and one in India, without the formation of viable embryos.
Their history included repeated pregnancy losses even before assisted reproduction. Two spontaneous abortions occurred at around three months, while another pregnancy ended at six weeks. Both natural conception and ovulation induction had failed to result in a sustained pregnancy. By the time they sought care in Hyderabad, age related risks were evident, particularly the increased likelihood of embryo aneuploidy.

A comprehensive reassessment at Birla Fertility and IVF Hyderabad revealed a critical factor that had not been sufficiently addressed earlier. The male partner was diagnosed with severe oligoasthenoteratozoospermia, a condition that significantly affects fertilisation potential and embryo quality. This, combined with advanced maternal age, sharply reduced the chances of success using the couple’s own gametes.
According to Dr. Alimileti Jhansi Rani, Consultant and Centre Head at Birla Fertility and IVF Hyderabad, repeating the same protocol was unlikely to change the outcome. “When a couple has had repeated cycles with no embryo formation at all, it is important to pause and reassess rather than push forward with the same approach. In this case, the male factor was playing a much larger role than initially recognised, and combined with maternal age, the chances with self gametes were extremely limited,” she said.

The couple was counselled extensively on available options. These included another IVF attempt using their own gametes with genetic testing, or proceeding with embryo donation to improve the probability of a healthy pregnancy. After careful consideration, they opted for embryo donation, acknowledging both the emotional complexity of the decision and the clinical realities of their case.
Prior to embryo transfer, a diagnostic hysteroscopy was conducted to evaluate and optimise the uterine cavity. Endometrial preparation followed in the next cycle, and a single embryo transfer was performed under close medical supervision.

The pregnancy test returned positive, marking a significant turning point after years of repeated disappointment. For the couple, the outcome underscored the importance of personalised decision making rather than persistence alone.
The case highlights a broader reality in fertility care. In long standing infertility, particularly beyond the age of 40, success often depends on recognising biological limitations, reassessing earlier assumptions, and selecting the option that offers the most realistic path forward rather than repeating approaches that have consistently failed.

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