After infertility and conceiving through IVF, this mum of 3 wrote a children’s book to remove its stigma

When Caryn Lim and her husband, Dr Tan Yung Khan, a urologist, first got married in 2015, starting a family was not on their minds. They were in their twenties and forties respectively and were enjoying their careers and travels.   

Just as they contemplated starting a family, Lim found out she had endometriosis.

Endometriosis is a condition where cells similar to the lining of the woman’s uterus grow outside the uterus – it can affect the ovaries, fallopian tubes and tissue lining of the pelvis.

Although the tissue is growing in places it shouldn’t be, the endometriosis tissues thicken, break down and bleed every menstrual cycle. The condition can cause cysts and pain for women, especially during their periods.

Endometriosis can also lead to fertility problems, which was exactly what Lim faced.

“The endometriosis was severe enough to cause me pain, even when I was not having my period. What’s more, I had a couple of ovarian cysts. Sometimes, passing motion would be painful too,” said the 36-year-old.

She decided on surgery to remove the ovarian cysts and endometrial overgrowth of tissues in the pelvic region to reduce the discomfort but also to give herself a chance at conceiving.

THE JOURNEY FROM INFERTILITY TO CONCEPTION

In 2018, after her surgery and recovery, Lim and her husband decided to conceive via intrauterine insemination (IUI). The process boosts the chances of pregnancy by injecting sperm into the uterus, reducing travel time to the woman’s egg.

Unfortunately, it did not work. “It was disappointment after disappointment,” she recalled.

After a year of unsuccessful attempts, the couple decided to try in-vitro fertilisation (IVF) in 2019. The multi-step reproductive process is generally viewed as one with higher success rates than IUI.

However, the journey was not without its setbacks. Lim said: “Having heard many IVF success stories, I embarked on it with a higher expectation of conceiving successfully. However, knowing the science is one thing – dealing with the physical, mental and emotional stresses are different things.”

Lim hadn’t realised that her endometriosis affected her egg quality so much that, even though her doctor retrieved 17 eggs, it resulted only in three embryos.

With only three precious chances, Lim proceeded with the first transfer. She said she did all the right things in her first trimester but lost the pregnancy. “I was sleeping, eating and resting well. But it was not successful and the disappointment was hard to bear. We took a long holiday away before coming back to try again.”

HUMBLED BY HER IVF JOURNEY

Lim said she was fortunate with the second transfer using the remaining two embryos, and conceived in 2019. The pregnancy was fraught with ups and downs – she experienced bleeding in the first trimester and was given progesterone injections to support the fragile pregnancy.

“The relief I felt after getting pregnant wasn’t permanent – now I had the pregnancy to worry about! I was praying several times a day that God would keep my pregnancy going.”

The IVF process can be exhausting – mentally and emotionally. Women will be given hormones to stimulate the process while coping with the waiting game of the time for egg retrieval, time for embryo transfer and transfer success. Lim said emphatically, “The IVF journey humbles you.”

She added that even though her husband, now 50, is a urologist and had helped many male patients and their families with their fertility struggles, nothing prepared him for the physical and emotional stress of his own journey with IVF.

A self-declared Type-A personality, Lim admitted that she had to reframe naive thoughts as she tried to conceive via IVF. “I thought that in whatever we do, as long as we work hard at it, we could achieve it.”

The IVF process changed that. “It forces you to surrender and understand that there are many things in life beyond your control. While IVF can bring up your chances at conception, it is not a 100 per cent guarantee that you will get pregnant. In fact, far from it.”

IVF SUCCESS – FROM ONE TO THREE KIDS

Her perseverance and tenacity paid off: In February 2020, Lim gave birth to her first son, Euan. “I was elated and relieved,” she said.

The couple decided to do another round of IVF, this time, transferring two embryos even as COVID-19 progressed.

To Lim’s surprise, both successfully implanted and she safely delivered her twin boys, Eben and Eliot, who are now two years old.

The turnaround of this fertility journey is not lost on Lim. Because of our Asian culture, open discussions about infertility and assisted reproductive methods are less common and there’s a stigma associated with it.

“It is a sensitive subject and in Asian societies. IVF can be isolating for many but it does not need to be this way. There is nothing to be ashamed of,” she said.

These preconceived notions caused a “hush-hush” mindset and one could go through the process without being able to talk to anyone openly, she added. She even had well-meaning friends who encouraged her to take more time to conceive naturally instead of getting fertility assistance.

“Looking back, if I had known that IVF was more common than I had thought, I’d have probably felt less alone. I just needed pure support.”

Thankfully, her husband was her rock. “As a urologist, he sees male patients with fertility issues all the time but he did not once worry that his own patients may view him differently even if their own doctor needed IVF himself.

“I feel that our experience made him a better doctor because he can identify and connect with these patients.”

A CHILDREN’S BOOK ABOUT IVF TO SHOW HER SONS HOW THEY CAME ABOUT

It was after Euan, now four, was born, that Lim, who works with her husband in his medical practice, was motivated to write her book, The Blessing. Due to COVID-19 restrictions, the family stayed home, and she read a lot to Euan.

While she could find many children’s books about how babies are made, there were none explaining the IVF process. “I wanted him to know how special he was and how much of a miracle it took for him to even be here.

“In this book, I have shared key moments in my fertility journey – moments that are etched in my heart.

“The story celebrates all babies – adopted, conceived through IVF or naturally. Simply because they are all blessings.”

Lim took six to eight months to work on The Blessing, collaborating with Lisa Wee, an author-illustrator who uses her illustrations to make such topics relatable to both children and adults. “I wanted a simple, symbolic and meaningful way to share the account of how my children came to our family.”

The book was launched in 2022. Its cover is a cheerful and bright illustration of a blooming orchid – a symbol of fertility and how it represents the journey of birth. Rhyming words bring the story to life, telling the conception journey – however it is done – in an easy-to-read manner.

Lim’s hope is that women are not defined by infertility. “I only found out that so many other women were going through this journey after I shared my own story. Through that, I felt consoled, supported and understood – and not alone in this.”

Through her book, she hopes to normalise fertility challenges and make infertility and even IVF non-taboo topics. “This way, we can let many families and women know they are not alone in this,” Lim said.

The Blessing, $25, is available at Owl Readers Club and on Natventure.sg