Cassie (UAE): Navigating new horizons
In 2014, I did my first IVF cycle at a big clinic in San Francisco, California. The clinic was very thorough and they meticulously prepared me for every step of our cycle. My husband and I attended a mandatory injection class where we learned how to administer all the meds we would use throughout the cycle and the nurses created a custom calendar for us with medication dosages to follow throughout the cycle. They sent me updated versions over email as the cycle progressed and things changed, and I got daily phone calls checking on me and giving me results of blood tests. By the time we did the embryo transfer I felt calm and confident, no doubt aided by the single Valium that they prescribed to keep me mellow for the transfer.
I was so thrilled when I got pregnant on the very first go! And that would have been the end of my story if I didn’t miscarry that baby at 12 weeks. Two weeks after my D&C my husband and I moved to Abu Dhabi in the United Arab Emirates.
Knowing that it was going to take another IVF to become pregnant, I started the search for a clinic all over again. I didn’t know anybody in my new home, let alone anybody going through fertility treatment, so I took to the internet and started wading my way through the information I found. I went to a very big IVF clinic in town that was always the first result every Google search. I had a consultation but didn’t feel comfortable there. I started to panic that I would be forced to do my next IVF with them simply because I didn’t know where else to go. At the time in Abu Dhabi there was very little information about where to go. Finally, someone told me about an American gynaecologist in town and she referred me to the small fertility clinic in the hospital where she worked. By the end of my consultation appointment with the doctor at that clinic I knew that I would be doing my IVF with them.
My second IVF was very different from my first. I had all my medical records from my San Francisco clinic so I was able to get started right away. I had to do a few blood tests and ultrasounds, but I had already done all the major testing and they were satisfied with that. As the cycle progressed I was very aware of how little information they were giving us. Everything was much looser and more casual than with my San Francisco clinic. For my first cycle, all my meds were ordered and delivered before my cycle began; with this one, I would pick up each medication on the day I needed to start using it. There was more than one occasion when the pharmacy did not have one of the stims I needed and I had to drive to every pharmacy I could think of until I found it. I once ended up injecting myself in my car in the parking lot of a pharmacy because, by the time I got what I needed, I was late giving it to myself.
My husband and I remarked to each other several times that we were glad we’d been through this before; had it been our first cycle we would have been much more anxious at how little we understood of what was going on and would not have known what to ask.
The UAE is one of the few places in the world where it is illegal to freeze embryos. That is starting to change now but at the time of our IVF it was strictly forbidden. That meant that I only had one chance to use my embryos. I had a good result from my egg retrieval and, this time, I insisted on doing genetic testing. Had I done that the first time I would never have transferred the embryo that I miscarried; I had testing done after my D&C and was told that the baby had a very common genetic disorder, which would have been caught if it had been tested before it was transferred. I wasn’t going through that again. I ended up with 11 embryos by day five, but only three of them were genetically normal. Since freezing was not an option, my doctor transferred all three. Although I was 38 at the time, I think I would have had a hard time convincing a US doctor to put back three embryos. Here in the UAE, it was not an issue. I was also offered the option of only transferring the gender of my choice. ‘Family balancing’, as it’s called here, is a big selling point of a lot of the clinics. I asked not to be told which genders were going in but it didn’t matter since they all went in anyway.
I ended up having a chemical pregnancy that time.
My doctor advised that I do another IVF exactly the same, not changing anything. He told me that he would tell me if he didn’t think it would work, but that he felt sure that it would.
That cycle was much the same as the one before, except this time I had 14 embryos and again only three genetically normal ones. Once more, I was scared of getting pregnant with triplets but I was terrified of not getting pregnant at all. We were really left on our own to decide what to do. We would have loved to have been able to freeze two of the embryos and transfer them one at a time but that was not an option. My husband and I decided to take our chances and put all three in.
I got pregnant with twins. It was a very anxious first trimester until I passed the point where I had miscarried after my first IVF. A few months later, I learned that I was having a boy and a girl. We could not have been more thrilled.
The rest of my pregnancy went very smoothly and my son and daughter were born at 37 weeks, which is full term for twins. They were strong and healthy. They just turned two and they are the lights of my life. They are worth every moment of struggle to have them.
Cassie has launched an IVF Support group in the UAE. You can reach her at www.ivfsupportuae.com or on Instagram at ivfsupportuae.