Patient Story

María del Carmen & Vinodh

Unexplained Infertility
Emily A. Evans-Hoeker, M.D.
Roanoke, Virginia
Blacksburg, VA
Frozen Embryo Transfer (FET)
Genetic Testing of Embryos
In Vitro Fertilization (IVF)

Hailing from Spain and Malaysia respectively, we (María and Vinodh) found a home in Chapel Hill, North Carolina, after meeting in graduate school at UNC Chapel Hill in 2008. We both were enrolled in the same Ph.D. program in Hispanic Studies. After finishing graduate work, we moved to Blacksburg, Virginia, in 2011 to take up jobs at Virginia Tech and quickly got married in 2012.

Finding fertility care at SGF

Five years later we started to try for a baby. After several months of not being successful, we were referred to Dr. Evans-Hoeker for treatment. Dr. Evans-Hoeker went over several treatment options for our diagnosis of unexplained infertility. She started us off with timed intercourse, before moving on to three intrauterine insemination (IUI) cycles that were unsuccessful. The next step for us was in vitro fertilization (IVF).

Our first cycle resulted in one genetically normal embryo, which was transferred in 2019. This transfer, sadly, was not successful. It was at this moment that Dr. Evans-Hoeker recommended that we undergo an ERA uterine biopsy to check María’s implantation window. The results showed that she needed extra hours of progesterone exposure. We then did a second retrieval in November 2019, which resulted in another embryo that was sent out for genetic testing. The initial report on the embryo was inconclusive, as there was insufficient genetic material in the sample. We decided to thaw and biopsy the embryo again, which had its own risks. The second biopsy thankfully returned a normal result. We did a second transfer with the new progesterone protocol in February 2020 and became pregnant with our beloved son, Marcos.

Hope amidst sadness

María had a healthy and happy pregnancy despite the COVID pandemic and wasn’t very worried when she was induced at 41 weeks. However, what was to be a joyous moment quickly turned to despair when Marcos’s heartbeat started falling and medical staff did not respond to help our son. Marcos passed away on November 12th, 2020, due to medical negligence, and María was rushed to the OR for a blood transfusion. The end of 2020 and the start of 2021 were characterized by mourning our son, engaging a legal team to seek justice against the hospital, and meeting with Dr. Evans-Hoeker to continue our fertility journey. January 14th, 2021, was the date of our next consult, and we waited with hope amidst sadness for that virtual conversation with her.

In our meeting Dr. Evans-Hoeker was compassionate, kind, and hopeful. She proposed that we continue with IVF, as Marcos had been a success; our appointments at the Roanoke clinic quickly became a guiding beacon for us as we bounced between extreme sadness and hope for a living child. We did another retrieval in March 2021, followed by an unsuccessful transfer in May. In August of the same year, we did another retrieval that resulted in one euploid male embryo. At this time, Dr. Evans-Hoeker was partnering with a different facility that wouldn’t allow us to transfer until December. With weeks ahead of us before being able to move forward, we decided to do a second retrieval in September. This is something that we had not previously done, but decided, at the moment, that it was a good idea because María was already 41. This retrieval resulted in two euploid female embryos — we were very excited because this was our first retrieval with multiple genetically normal embryos.

December 2021 was an emotional rollercoaster for us. On the 8th we transferred one female embryo, and on the 15th, we had our successful mediation with the lawyers and the hospital. On the 17th we found out that the transfer had worked and that we were expecting a baby girl! The holidays came and went, with a visit from María’s parents from Spain, as we were all overjoyed with the pregnancy. On January 11th, however, a routine ultrasound found that our little girl was no longer growing – we had had a missed miscarriage. We waited another week to confirm this diagnosis before proceeding to a D&C. This surgery was followed up by a second intervention to remove retained products of conception (RPOC).

In summer 2022, we had a transfer cancelled because the uterine lining did not thicken enough. A few weeks later, things did work out and we transferred our baby boy embryo. The joy of a positive pregnancy test was, however, quickly overshadowed by a second test in which the HCG was not doubling adequately. Dr. Evans-Hoeker confirmed that we had had a chemical pregnancy.

Finding a new plan forward

We sat down with Dr. Evans-Hoeker and her amazing team to go over what we could do to make the transfer of our last embryo a success. They suggested that María undergo laparoscopic surgery to check for endometriosis and a hysteroscopy to check for any uterine imperfections. María underwent this surgery in November 2022. For the transfer protocol, Dr. Evans-Hoeker added some additional medications, and we transferred our baby girl on February 17th, the same date as the transfer of Marcos.

This was a very emotional moment, as the procedure connected both our babies together in a very meaningful way. The transfer was a success, though we were cautious at every step since we had already gone through a missed miscarriage and a chemical pregnancy. Our baby girl’s due date was November 5th, one day after her brother’s date since he was born in a leap year.

As in Marcos’s pregnancy, María had an uneventful pregnancy, but was now scheduled for a programmed C-section at 38 weeks. Also, she underwent weekly ultrasounds and NSTs after week 31.

Our rainbow baby girl

Our rainbow baby girl — Flor Venkatesh-Caña — was born on October 25th, 2023. On the morning of delivery, Nurse Terri, who had become a pillar of support throughout our fertility journey, came to the hospital to be with us, as she understood just how triggering and difficult things were going to be given our history. She was with us throughout the wait for an operating room to open and was with us in the delivery room as baby Flor was born. She also reassured us as things became complicated — though Flor was doing great, María had a hemorrhage that would not stop, and the doctors had to take emergency measures that included a blood transfusion. Terri only left our side once María’s vitals had stabilized, and returned a few hours later with Dr. Evans-Hoeker to visit; they both held baby Flor and took many photos with her and even showed us how to swaddle her. Dr. Evans-Hoeker’s team is definitely part of our family!

Love and care

After three IUIs, 6 IVF cycles, five additional surgeries, the killing of our beloved Marcos, a missed miscarriage, and a chemical pregnancy, we now hold our beautiful baby Flor in our arms.

The journey was not easy, but it was definitely worth it. The love, care, and professionalism shown by Dr. Evans-Hoeker and her entire team brought us a light of hope when things looked darkest. We will forever be grateful to this team for giving us our most precious babies, Marcos and Flor. For future patients, we would tell them to trust in the medical team as they truly want you to be successful in your fertility journey; they are professional and realistic about the treatment options and want what is best for you and your family, all while keeping you as the patient in mind.


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Diagnosis and treatment

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Infertility terms
In vitro fertilization (IVF)
Preimplatation genetic testing
Frozen embryo transfer (FET)

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Roanoke, Virginia, location
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