New fertility treatments offer hope of reversing declining birth rates in UAE

Science helps Emirati couple welcome first child after five years of trying

The number of couples entering parenthood is falling, but statistics show there is more to it than fertility issues. Getty Images

An Emirati woman has defied the odds by giving birth to a healthy baby boy thanks to a scientific breakthrough, five years on from her first attempts at starting a family.

Hussa, 42, was given a pioneering treatment of breast cancer drugs, repurposed to restore her uterus to optimum health, allowing her to conceive.

When that was paired with a genetic test to ensure her eggs were in the best possible condition for fertilisation and a new technique removing them at a smaller growth stage than usual, Hussa and her husband Ahmed were told they had a successful pregnancy.

The procedure at the Art Fertility Clinic in Abu Dhabi is the latest example of how personalised medical care is helping deliver the best possible outcome for patients.

Fertility and birth rates around the world are on the slide due to economic, environmental and lifestyle factors.

But with similar successes and new scientific discoveries, doctors hope that can be reversed to resolve the issue of declining populations.

“It's extremely important to realise that fertility is a very new field of medicine,” said Dr Human Fatemi, a consultant in obstetrics, gynaecology and reproductive health at Art Fertility Clinics.

“IVF treatments have existed for only 45 years, whereas ophthalmologists, cardiologists and many other fields have been there for centuries. It means our knowledge is extremely poor and why research is important to go one step ahead.

“Now, we have reached the era of individualised medicine, it’s not a one-size-fits-all approach any more. Every month, the endocrine profile of a woman differs, so the way you approach stimulating a woman for IVF is different.”

Dr Human Fatemi is a consultant in obstetrics, and gynaecology and reproductive health at Art Fertility Clinics. Victor Besa / The National

Multiple techniques

Hussa, who lives in Abu Dhabi, had been experiencing primary infertility for more than four years, with a history of endometriosis and severe adenomyosis, a condition where tissue that normally lines the uterus grows into its muscular wall.

The couple underwent an intracytoplasmic sperm injection using frozen sperm from the Micro-TESE procedure, a technique that extracts sperm directly from the testes.

The resulting embryos were subjected to preimplantation genetic testing for aneuploidy, which identified a single euploid embryo suitable for transfer.

Then, a carefully designed five-month course of Decapeptyl 3.75 and Letrozole, two drugs used for breast cancer, was initiated, followed by a uterine wash and hormone replacement therapy.

A first procedure took place during the pandemic, but when Hussa caught Covid-19, she lost the pregnancy.

A second attempt proved a resounding success, with Hussa giving birth to a healthy baby boy five months ago.

The couple now hope by revealing their struggles they can inspire others to not give up hope of starting a family.

“We used to operate on these type of cases, or suppress hormones with injections, but the success was very limited so we just tried to think a little bit out of the box,” said Dr Fatemi.

“When we scanned Hussa’s uterus, it was pushing against her lungs, which I have never seen before. We looked to combine these cancer drugs, plus the treatment of suppressing the hormones.

“After five months, the results were extraordinary and she had almost a completely normal uterus. If you see this kind of success, there is a light at the end of the tunnel. Standard IVF doesn't exist any more.”

In a world where fertility rates are steadily declining due to the fast-paced, high-stress lifestyles of modern couples, comprehensive, tailored approaches towards fertility are offering a viable path forward for hopeful parents.

Plunging birth rates

According to the UN’s World Fertility Report 2024, the fertility rate in the UAE has dropped dramatically, from 3.76 live births per woman in 1994 to just 1.21 in 2024.

It is a familiar pattern around the globe. Fertility rates in India have dropped from five to two births per woman since the 1970s, while in South Korea a total fertility rate of around six births per woman in the 1950s has plummeted to less than one in 2023.

Dr Fatemi said there were a number of contributing factors. “The prevalence of infertility in the Gulf is significantly higher than what we see in the West,” he said.

“Key reasons are environmental and lifestyle. When you cover yourself, you have a lack of sun exposure, leading to a decline of vitamin D.

“This decreases the number of eggs, so women go earlier to menopause because they're fully covered and have no sun exposure.

"Other factors are consanguinity and obesity. In married cousins, daughters have a reduced ovarian reserve and go earlier to menopause.

“Also, a lot of physicians do elective C-sections in this region, as they think this is the easy way to go, but those C-sections also reduce the receptivity of the uterus.”

According to the Gulf Research Centre Foundation, fertility in Oman fell from six babies per woman, on average, in 1995 to four on 2016.

In Saudi Arabia, the number fell from 3.6 in 2004 to 2.4 in 2016, and from 4.4 in 1997 to 3.2 in 2015 in Qatar.

New parents Hussa and Ahmed, however, are looking forward to an exciting new future.

“I knew we would be happy if we had a child, I was on medication and I was suffering, despite that I always had hope,” said Hussa.

“Dr Fatemi gave me that energy to come back after we had been trying for so long. I always wanted to get the feelings of being a mum and having a family of our own. I knew it would make our lives very different. It has made me happier.

“Family is a very important part of our culture. We need to have kids and actually we love a big family. But from my side, a small family is more than enough.

“If I could speak with any other couples who may be struggling, I would tell them to be patient, you will get good results eventually if you keep trying.”