Fertility Files – Real Cases of Infertility Challenges

From Severe Uterine Damage to a Confirmed Pregnancy

18 years of infertility. A severely damaged uterine lining. Multiple medical challenges, including HIV. For years, pregnancy wasn’t just difficult, it seemed out of reach. Because even when embryos are available, implantation depends on one crucial factor: the uterus being ready. Today, she has achieved a confirmed pregnancy after a journey defined by persistence, precision, and regenerative care.

- Birla Fertility & IVF, Ahmedabad, (Dr. Nimisha Shantilal Pandya)

Case Snapshot

Patient AgeFemale: 42 years

ChallengesSeverely thin endometrium, intrauterine adhesions (Asherman-like condition), long-standing infertility, HIV, advanced maternal age

TreatmentHysteroscopy with adhesiolysis, PRP therapy, hormonal therapy, donor IVF, embryo transfer

OutcomeSuccessful pregnancy (early confirmed)

Timeline~10–14 months

Journey Timeline

1. Complex Challenges

2. Personalised Plans

3. Safe Retireval & Transfer

4. Guided Transfer

5. Successful Pregnancy

The Barriers They Faced

Severely Thin & Irregular Endometrium

Not ideal for embryo implantation.

Dense Intrauterine Adhesions

Distorted and restricted the uterine cavity.

Long-Standing Infertility (18 years)

No prior successful pregnancy.

Advanced Maternal Age

Required donor oocytes for better success chances.

Endometrial Receptivity Issues

Even with embryos, implantation likelihood was low without intervention.

Doctor's Quote

“The key was to tailor every aspect of care to this patient's unique needs, balancing safety, comfort, and clinical effectiveness.”

— Dr. Nimisha Shantilal Pandya

The Treatment Plan that made the Difference

Hormonal Preparation

The patient was started on estrogen therapy (Progynova) to stimulate endometrial growth. Initial scans showed a thin, patchy lining (6.5 mm), indicating the need for further intervention.

Hysteroscopic Correction

First Hysteroscopy: – Severely fibrosed, tunnel-shaped uterine cavity – Dense adhesions and a small polyp Procedures performed: – Adhesiolysis (removal of adhesions) – Polypectomy

PRP Therapy (Regenerative Approach)

Multiple intrauterine PRP (Platelet-Rich Plasma) sessions were administered to stimulate endometrial healing and growth. → Result: Mild improvement, but still not optimal

Advanced Surgical & Regenerative Intervention

A second hysteroscopy was performed with: – Further adhesiolysis – Dilatation & Curettage (D&C) – Sub-endometrial PRP injection Followed by continued hormonal therapy and additional PRP support.

Endometrial Optimisation

Follow-up showed improved endometrial thickness (6.9 mm) with better structure, sufficient to proceed with embryo transfer planning.

Donor IVF & Embryo Transfer

IVF was performed using donor oocytes. A double embryo transfer was carried out under carefully optimised conditions.

A Story of Rebuilding Hope

This case is a powerful example of what modern fertility care can achieve—even in the most difficult scenarios. When faced with: – Severe uterine damage – Long-standing infertility – Complex medical conditions Success didn’t come from a single step, but from a layered, persistent approach: – Surgical correction – Regenerative therapy (PRP) – Hormonal optimisation – Donor IVF At Birla Fertility & IVF, this combination helped transform a uterus once considered unsuitable for implantation into one capable of supporting new life.

The Outcome

β-hCG levels were strongly positive (>1000 mIU/mL).

Ultrasound confirmed an intrauterine gestational sac, indicating a successful early pregnancy.