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When Fakhera, 24, and her husband got married in 2018, they were eager to start a family. Four months later, Fakhera became pregnant and the couple's joy knew no bounds. But at her 21 week anatomy scan, they received devastating news: their baby had multiple problems including a rare condition called Diaphragmatic Hernia, which would cause the baby to pass away shortly after birth.
The couple turned to doctors in Boston, USA, who confirmed the parents’ worst fears, that there were indeed multiple abnormalities including Diaphragmatic Hernia and were told that their baby was unlikely to survive.
Fakhera gave birth to a baby boy at 8 months, but just minutes later, he passed away.
“We were told to stay positive as it’s a rare condition and unlikely to strike more than once,” Fakhera said.
After that experience, Fakhera and her husband turned to In Vitro Fertilization (IVF), a cutting-edge fertility treatment which is covered by the UAE government's national insurance, Thiqa. IVF is a process whereby a woman’s egg(s) are collected from the ovaries and fertilised with her partner’s sperm in a culture medium in a laboratory before being transferred in the womb in the hope it will achieve a healthy pregnancy.
IVF is the most effective form of assisted reproductive technology (ART) and has become increasingly utilised since it was first developed by British scientists in 1978. There are many reasons why people might turn to the treatment, including ovulation disorders, endometriosis, uterine fibroids, reduced sperm function or production, unexplained infertility and if one or both partners are carriers of a genetic disorder. According to Harvard Business Review, IVF is still a luxury service for most people, with research showing that 80 per cent of Americans who undergo fertility treatments have little to no insurance coverage.
Fakhera explained, “We did PGT-A testing (Preimplantation Genetic Screening for Aneuploidies) on the embryos and we were hopeful. Two embryos tested normal following the cycle.” Ecstatic at the results, the couple decided to transfer both, hoping that because they were unrelated and come from different families, the likelihood of there being multiple problems again were slim. “But again, at the 21 week anatomy scan, we were told that both our babies had the same issue.”
Fakhera and her husband suffered three pregnancies in a row where the same unique conditions were present.
More advanced genetic testing at an advanced fetal medicine unit at a government hospital in Abu Dhabi revealed that both the couple and the babies had the same mutation in the PIGL gene inherited from both parents which can cause neuroectodermal syndrome, known as CHIME syndrome.
Fakhera gave birth to twin boys at 7 months, with both tragically dying shortly after delivery.
Less than a year later, the couple decided to try IVF again and underwent a cycle this time with more extensive and precise testing carried out on their embryos, as PGT-A alone would not be able to detect particular conditions.
According to Fakhera, "Experts recommended complete genetic testing, not just of chromosomes, but of broader conditions. The process took more than 6 weeks and involved the samples being shipped abroad; were told that out of the 5 embryos we had, 4 were affected by the same condition and only one was free of the disease. There were question marks all around but we decided to transfer that one genetically normal embryo.”
Today, Fakhera is the proud mother of a healthy 2-year-old son named Nasser.
“I had a big chance of getting a sick baby if I tried naturally. IVF changed my life, losing three babies in a row, I never imagined I could have a healthy baby,” she added.
With all the challenges they faced, one thing that the couple didn’t have to be concerned with was covering the potentially exorbitant IVF costs. All their IVF rounds and genetic testing were fully covered under Thiqa.
With an average IVF cycle in the UAE costing around AED38,000, enjoying such benefits makes an already stressful process a little more manageable.
And Fakhera’s joy is obvious when she gratefully expresses, “I feel so happy and blessed when I look at my son now. He is so precious and spoiled by everyone in the family. IVF changed my life.”
The UAE government's investment in fertility care and treatment stems from a desire to promote a healthy population and secure the nation's future, said Dr Muhammad Akhtar, Consultant in Reproductive Medicine and Infertility at First IVF Fertility Centre, Abu Dhabi.
"The UAE is one of the top countries in the world to provide citizens with such an opportunity to have a family. What the UAE government and leadership are doing is visionary. They are preparing for the next generations, empowering them to receive the best care available within their country."
In the UAE, Emiratis insured under Thiqa can take advantage of up to 6 IVF cycles per year.
“When you place a limit on the number of cycles, you limit your overall chances of success, which citizens here don’t have to worry about,” added Dr. Akhtar.
“By comparison, the UK offers eligible patients 3 cycles a lifetime,” he explained. “In the US, few states offer funded IVF and where available it is mostly personal insurance-based and is rarely fully covered,” he added.
Fertility preservation is also offered under the Emirati insurance plan. “A woman diagnosed with endometriosis, cancer or an auto-immune disease, for example, will have the choice of freezing her eggs or opting for egg pooling.”
One reason why Dr Akhtar believes the government is investing so much in fertility treatment is because they care about the future of its people. “I find the leaders of this country very caring and compassionate about the population. They would like to see a future, they want to have a healthy population and do what they can to help the population grow.”
Although IVF success rates vary greatly, according to the UK’s National Health Service, in 2019, the percentage of IVF treatments that resulted in a live birth was 32 per cent for women aged under 35, 25 per cent for women aged 35-37 and 11% for women aged 40-42.
"There is no set number [of cycles] per lifetime as such for Emiratis insured under Thiqa, as access is available, because you never know, maybe just one egg or sperm might be the key,” Dr. Akhtar noted.
Asma, 33, and her husband also benefited from the UAE's IVF programme when they struggled to conceive after marriage. “There was a lot of pressure, from family as well as others asking uncomfortable questions,” she said. “We went to get checked and my husband was diagnosed with Azoospermia and we were told the only way to get pregnant was through IVF.”
Azoospermia is the absence of sperm in male ejaculate, and accounts for about 10-15% of men’s fertility challenges. However, it is still possible to achieve pregnancy with a biological child through IVF and/or intracytoplasmic sperm injection, whereby a doctor can extract viable sperm from the testes using a tiny needle.
After a successful IVF cycle at a private clinic in Abu Dhabi, Asma and her husband delightedly welcomed a baby girl and later returned for a second treatment which resulted in another healthy baby girl. "We are so lucky that it worked for us,” Asma shared, adding, “It is such a blessing that we don’t have to worry about the financial burdens of fertility treatments as they are very expensive. So many people spend a small fortune on trying for a baby. We are truly lucky.”
Having access to fully covered cycles of IVF can also increase the chances of pregnancy success for women of advanced maternal age in several ways, says Dr. Laura Melado, Specialist Reproductive Medicine and Infertility, Medical Director at ART Fertility Clinics. “They can undergo multiple attempts, optimizing the treatment plan and thus increasing their chances of success by allowing them to continue trying until they achieve a positive outcome,” she explained.
“We should not forget that IVF can be emotionally and financially stressful, and a fully covered cycles programme reduces the financial burden and anxiety associated with the cost of treatment. Reducing the stress for these women may have a positive impact,” she added.
One such patient is Wadha, who tried to get pregnant with her husband for more than 25 years before turning to the ART Fertility Clinic in Abu Dhabi.
“Wadha was diagnosed with Polycystic Ovarian Syndrome (PCOS) and her husband with male infertility factor, and had undergone several failed treatments in other centres,” said Dr. Melado.
“When the couple came to our clinic, Wadha was 45 years old, a factor that reduces the egg quality and generates more chromosomally abnormal embryos. We recommended that they undergo IVF followed by PGT-A genetic testing on the embryos before implantation to ensure that only chromosomally normal embryos are transferred to the uterus.”
The couple underwent multiple IVF treatments and were unsuccessful due to low embryo quality, chromosomally abnormal embryos, and issues related to advanced maternal age and male infertility factor.
However, in 2022, one good quality and normal PGS-tested embryo was transferred and Wadha became pregnant, later delivering a healthy baby.
Dr. Melado explained that some of the more common causes of infertility in the Emirati population are PCOS, male infertility factors (such as low sperm count, poor sperm motility, or abnormal sperm morphology), problems in the fallopian tubes, and endometriosis.
“However, men and women from the UAE have other specific problems with important impact on their fertility, including consanguinity, obesity and chronic vitamin D deficiency. These factors can be highly prevalent in the Emirati population, reducing the chances of having a healthy baby,” she added.
Thanks to the UAE's world-class IVF programme, countless Emirati families have overcome the hard and painful road to parenthood, ensuring a brighter future for them, their families, and the nation as a whole.
The latest Department of Health (DoH) policy of Thiqa coverage for assisted reproductive treatment and services, states the following patient eligibility:
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