Anonymised clinical case pathways illustrating how Dr. Bhoomika Upadhyay approaches complex fertility and reproductive challenges.
Male Infertility/Azoospermia
We found a way forward with own sperm.
The couple came with a significant fertility challenge: the woman had PCOS, while the husband had azoospermia. They were not willing to use donor sperm and wanted to explore every possible option using his own sperm. After thorough examination and hormonal evaluation, the couple was counselled about the available options.
Micro-TESE was performed to look for sperm directly from the testes, and sperm was successfully retrieved. ICSI was then performed, embryos were formed and transferred, and the patient conceived. She subsequently delivered a healthy baby boy.
Low AMH
I wasn’t ready to give up on my own eggs.
At 38, with an AMH of 0.5 ng/mL, the patient and her 42-year-old husband were looking for one more chance to conceive with her own eggs. Other doctors had suggested donor eggs, but she was not ready to give up on that possibility. She came to us determined to explore what could be achieved with her own eggs.
In the first stimulation cycle, one mature egg was retrieved and developed into a blastocyst. In the second cycle, another mature egg was retrieved and again developed into a blastocyst. Both blastocysts were transferred, resulting in a twin pregnancy. She went on to have a successful delivery and is now a happy mother of twins.
Low AMH, Successful IUI
Despite low AMH, I conceived with my own eggs.
At 36, she wanted to conceive using her own eggs, despite an AMH level of just 0.23 ng/mL. During ovarian stimulation, her follicles ruptured prematurely, even after measures were taken to prevent an LH surge. The unexpected development posed a challenge to the treatment cycle.
Rather than abandon the cycle, the team proceeded with IUI in the same cycle. The decision led to a positive outcome: pregnancy was achieved and is ongoing. For the couple, this was a hopeful milestone in their fertility journey, showing that even when treatment doesn't go exactly as planned, an individualised approach can offer a way forward.
