This couple from Ghana are happy today thanks to the IVF treatment that they underwent at the Malpanis...

I had a vasectomy in 1981, thinking that I would not have any more children, as my marriage was fine, and we had 3 children, all girls, but 3 was enough. Unfortunately, after 18 years the marriage failed, and some years later, I left the UK and settled in Africa, where I met and married a girl some years younger than I was. Obviously, she wanted children, and as things had been going very well with us for some time, I decided to see what could be done to achieve this.

As we were living in Africa, we started looking there, and found that a clinic in Dakar, Senegal had recently started doing IVF. I was going for IVF and ICSI as opposed to a reversal, as the time lapsed from the vasectomy was now some 30 years, and highly likely to be unsuccessful.

We made contact with the clinic, (Cinique du Cap) who started us on a programme. After a number of tests were carried out at the clinic, and much travelling, I had an operation to remove sperm for freezing until the ICSI was done. The professor, who was supposed to carry out the operation, having done all the consulting and scanning on me, was late, and as we had some distance to travel, another man carried out the operation, but I believe his speciality was the female side, not the male, but he was good. I chose to have a local anaesthetic, but as he was not so sure about what was what, they gave me a general at their expense, putting me to sleep! The removal was done by inserting a needle down the short vas deferens towards the epidydimis, and extracting sperm from it. It obviously worked, as they got what they needed.

Then my wife was set for the operation, and given many drugs and tests to prepare her for producing as many eggs as possible, ready for the ICSI, then transfer.

Unfortunately, the medication, of which I have a record, was excessive, and she was not so well during this time. They would not tell her, or me anything about what was going on, how many eggs recovered or how many eggs fertilised etc. Even the medical staff there, were afraid to ask anything, and got the medication wrong once as a result! I sent an email asking what had been done and shortly after, got a phone call from my wife, saying that she had been told of because I was bothering the doctor! We still were not told what was done. A few days after the embryo transfer, and we were actually told it was 2, the receptionist told my wife that she could go home, some 300 miles away, so she went. She was not feeling well at this point, but followed the instruction.

Two days later, she was bloating, short of breath and in pain. I went on the web to see if I could find out anything that could help, and found out about the dreaded OHSS ( ovarian hyperstimulation syndrome) , which can KILL!

We phoned the clinic, and were told to get back there as soon as possible, which we did, but were still not able to see the doctor until the next day. When he was my wife, he took her in first, ahead of the others waiting, and took her to the operation theatre, where they drained about 4 litres of fluid from her abdomen. The next day they drained another 3 litres.

It turned out that she had moderate OHSS, and was in a bad way as a result. Then the doctor asked us why she went home, so my wife told him. He was angry that she had done what his secretary had told her to do, and said that he had not said she could go, so she should have stayed!

Anyway, we went back for the Beta test to see how it was going, and it was positive, but low on the first test.

Then, a week or so later, my wife woke up in pain, and shortly after, started a light period that lasted the usual 4 days. We told the clinic and he was not concerned at all! The next test still showed positive, but still low. The week after that it was only 2, but they way he explained it, my wife thought there was 2 embryos, which caused some upset when she understood what he was really telling us. He then recommended that if we wanted to try again, we should go to Spain! We were both sure that the transfer was not done right, and that the injections of HCG she was having every other day were giving the positive readings.

We STILL had no idea about what had been done, and the numbers anywhere, no report, nothing. Worse was the fact that were NOT told about the possibility of OHSS, which can be fatal!

We left things for a couple of months so that my wife could settle down and recover from what was a bad time for her, and not so good for me, with the effect it had on her, and the disappointment of what was done, and lost!

I then started to look around on the net, and found a couple of clinics in Barcelona that seemed to be OK, and made contact with them. One of my customers just happens to be a Spanish medical professor so I asked her if she could find out anything about them as I was not going to go through all that hassle again. After a while, she got back to me, saying that they were more interested in the money than the results, which were overstated anyway. So that route stopped. I looked all over, including Europe, and the UK, but they were not really interested, and the costs were very high. Also, the time the patients have to spend on site was far too long, and expensive.

I was told by a couple of clinics that we had to have a report prepared by the last clinic, as a reference and guide as to anything they should be aware of, so I emailed the clinic in Dakar, asking for a report, IN ENGLISH, and got one, in FRENCH!

THEN I found the MALPANI clinic in Bombay, India, and they seemed to know what they were doing, and seemed very professional. I emailed them, adding a copy of the report I had from Dakar, asking if it was possible to get someone to translate it for me, as I had not been able to as it was too technical.

The very next morning (there is a 5 hours time difference between our two countries) I got a reply, AND the translation of the report! I was amazed at this, and told the doctor later, and he told me that he had cheated and got it translated using GOOGLE. But the fact remains that he DID it, for which I was grateful, but horrified at the content!

The report stated that there had been 30 eggs removed, 11 fertilised and 2 transferred. We were not told about any of this, as I have said, and HAD we been, we would have asked for the 9 remaining to be frozen for another attempt, thereby saving the risk of OHSS again. They would not tell us what happened to the 9 embryos, or anything else, so what DID happen to them? I know that there is a demand for donor embryos, and the cost to the recipient is high, so is that where they went?

Anyway, we spent a while emailing Dr Malpani, getting our doubts clarified . He really could not be more helpful, and where he gets the time for it all I don't know, as there are many more patients doing exactly the same!

We were so happy with everything that was discussed that we decided to go to India for the second attempt, and found that the cost of the operation and medication was far lower than anywhere we had contacted so far, but it did not seem that it was so cheap that it was not professional, everything was so reassuring.

We got to Bombay, and saw Dr Malpani, who was an absolute gent, very polite, helpful and interested in everything that had happened and was going to happen. Then he explained what was to happen, which we had experience of already, but this time it was so different.

He did a scan on my wife, and found that she had POCD, or ovarian cysts, which probably rendered her infertile anyway, but was CERTAIN to cause OHSS!

We started the course of treatment, which was assisted by the most helpful staff I have known. The whole setup was fabulous from the word go, how different from our last experience! We were kept informed at every stage with regular checks to see that all was well, especially my wife. She started the treatment and had regular scans to keep an eye on the cysts and egg development, and the dosages were monitored and adjusted as required. As for the dreaded OHSS, she did have some discomfort, but no bloating or anything like she suffered before. Wonderful.

Then came the big day, I had a testicular biopsy done, to get what they needed, and then they removed 34 eggs from my wife. Then they fertilised the eggs and started them growing, all within a few hours, so that everything was fresh. The remaining embryos were frozen. We were told about everything as it was happening.

The medication then stopped, which was nice, and after 3 days, we went back to have the eggs transferred. 3 were transferred after consultation with the doctor about the risks of having too many. When we went for the transfer, we were asked if we would like to SEE the embryos that were going to be transferred, and of course we said yes, and got a full explanation of what we were looking at.

My wife then rested for a few days before we returned to Africa, and were already very confident of a positive result, which we were told also helps.

We were given a folder with full details of what had been done, and the numbers involved, and what to do next and when. We even got a photo of the embryos that we had seen under the microscope! Even now, we would like to thank the doctors and the nursing staff there who were so good. Dr Malpani's wife is also working in the clinic, and is also extremely helpful and professional. She looks after the scanning side and many other things with her husband, a perfect team.

While we were there in the waiting room, we made contact with a number of other patients, some of whom had travelled many thousands of miles for the treatment, which in every case that we spoke to, had been successful. One in particular had come from Sri Lanka, and they told me that they had been trying for over 10 years, travelling to many countries, including Europe. The wife was 3 months pregnant at the time, and were back to thank the doctors for helping them.

In our case, we were told that we should have a scan carried out after 4 weeks, to see how many embryos had stayed. We found that one had stayed, which was what we wanted, as we did not want to have to reduce the number in the future. We were also told that the embryo was 6 weeks, which was a bit confusing. We were working on the actual date of conception, as we knew it, but the rule of thumb seems to be worked out from the first day of the last period, making it 6, so we changed our calculations, bearing in mind that we did know the actual date.

As time was going by, my wife was in a bit of pain, so we asked Dr Malpani about it, and he explained exactly what was happening, and how long it should last for, which was correct.

Some weeks later, we had another scan carried out by an outside specialist who we were put in contact with by the friendly professor who advised us about Spain. The scan showed the baby moving around with all it bits, and we were so pleased.

We are now on week 19, all is still well and we are still in regular contact with Dr Malpani, who is keeping an eye on developments.

Week 24 and we had a high quality scan done. We now know that the baby is a girl, but also that there is a mild increase in the amniotic fluid. Need to watch that. We then got to week 31 and the fluid was far too high now, creating fears of the baby being premature, so our Cuban specialist here prescribed a course of Betamethasone, a steroid that makes the baby's lungs develop quicker. After checking on the net, and getting the OK from Dr Malpani, my wife had the course, which was no problem.

The fluid level stayed high, causing some discomfort, at times quite bad. At week 32, it was so bad that our specialist had to drain 1/2 a litre of fluid from my wife, and told us that this could also contribute to an early delivery. He was not happy about doing this, as it is quite a dodgy process, but didn't have much choice. All was well then until week 34.

At exactly 34 weeks, my wife called me at work, saying that her waters had broken, but not forcibly, just a gentle flow, which gave us time to get to the hospital. Two hours later the labour started, and after another hour, the baby was born. It was all over before my wife had learnt what to do!

We now have a beautiful baby girl, who is perfect and at the time of completing this report, is two months old, and growing fast.

We can't thank Dr Malpani enough, and are already looking forward to the next one !

Many thanks Aniruddha and staff. We hope to see you in about 18 months.

dave.paget@qanet.gm