Anonymised clinical case pathways illustrating how Dr. Vedika Maheshwari approaches complex fertility and reproductive challenges.
Low AMH, Age 35
I thought low AMH meant I was running out of time.
At 35, she came to us deeply worried after learning that her AMH was very low. After years of trying to conceive and unsuccessful ovulation induction, she feared her options were running out. Previous attempts had not resulted in pregnancy, and investigations showed very low ovarian reserve, with only a few antral follicles visible on her scans.
Instead of focusing only on her AMH levels, we assessed her ovarian response and planned treatment accordingly. Careful stimulation produced two mature follicles. One egg was retrieved, fertilised through ICSI, and developed into a good-quality embryo. We proceeded with an embryo transfer, and her pregnancy test came back positive. Her journey turned uncertainty into renewed hope.
Severe Male Factor Infertility
We thought our dream was over when the report showed no sperm.
The couple came to us after a semen analysis showed no sperm in the ejaculate. Previous hormonal treatment had not improved the results. Further evaluation suggested obstructive azoospermia, a condition in which sperm production may be preserved, but sperm cannot reach the ejaculate. They were anxious about whether having a biological child was still possible.
We explained that finding no sperm in the semen does not necessarily mean the testes are not producing sperm. Following appropriate evaluation, we planned a surgical sperm retrieval procedure. PESA successfully retrieved sperm, which was used for ICSI with the partner’s eggs. The embryo transfer resulted in a positive pregnancy, and the couple’s journey ultimately led to the birth of a healthy baby boy.
Tubal Factor Infertility
We thought IVF was our only option. Then we found the real problem.
After years of trying to conceive, the couple came to us following unsuccessful fertility treatment elsewhere. Evaluation revealed a hydrosalpinx, a condition in which a fallopian tube fills with fluid and can affect implantation. We explained why addressing the tubal problem before proceeding with IVF was important for improving their chances of success.
We planned treatment in stages, addressing the tubal condition before embryo transfer. After appropriate management and recovery, the couple proceeded with IVF. A good-quality embryo was transferred, and the pregnancy test came back positive. What had felt like another uncertain chapter in their fertility journey became a hopeful milestone, with the underlying tubal issue identified and addressed before moving ahead with treatment.
