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It was late one evening when my dear friend Giovanni, an embryologist from Italy, called me. His voice was more serious than usual, and there was a weight to his words that I could tell was both emotional and reflective. Giovanni and I had known each other for years through our shared passion for reproductive medicine, but this call was different. He had something to tell me—something that would stay with me for a long time.
"I have to share something with you," Giovanni began, his voice heavier than normal. "I think you should know about this patient of ours. It's not a typical case—it’s one that stays with you."
Intrigued, I leaned forward. "What happened, Giovanni?"
He paused for a moment before continuing, and I could hear the long breath he took before speaking again. "This woman, Laura, came to us a few months ago. She’s in her early 30s, a teacher by profession. Her story wasn’t unusual at first. She had been through multiple pregnancies, but tragically, she had experienced several miscarriages in the past few years."
I nodded, understanding the gravity of such a situation. As embryologists, we encounter such cases often. But what Giovanni was saying didn’t sound typical at all.
"Laura came to us after she had another miscarriage. This one was especially difficult for her—emotionally and physically. We began her evaluation, running all the usual tests for recurrent pregnancy loss: genetic screening, uterine evaluation, and immune testing. But nothing showed up that could explain why her pregnancies kept failing," Giovanni explained, his words deliberate, almost as if he were still processing the events that unfolded.
"Did you find anything?" I asked, eager to understand more.
Giovanni hesitated for a moment before answering. "No, everything came back normal—at least on paper. But Laura was insistent. She kept saying there was something else wrong. Something she couldn’t explain. And that’s when we began to dig deeper. What we found... well, it was a revelation that none of us saw coming."
I could feel the tension in his voice as he continued. "We did a routine ultrasound and some additional blood tests, just to be thorough. And that’s when things began to unravel. Laura’s test results weren’t just abnormal—they were alarming. Her hormone levels were all over the place, but the real shock came when we found a mass in her pelvic region, a large tumor that was quite rare. I sent her for a biopsy, and we discovered that she had cancer."
The word "cancer" lingered in the air between us, a grim reality that, once known, would change everything. I could feel my breath catch in my chest as I processed Giovanni's words.
"Wait—so, you’re saying the miscarriages weren’t just random? They were linked to this disease?" I asked, disbelief creeping into my voice.
Giovanni sighed deeply. "Exactly. You see, Laura had been miscarrying all these years because of the cancer—something that no one had suspected. The tumor was affecting her hormonal balance in such a way that it was preventing her from carrying the pregnancies to term. It’s a rare condition, but not unheard of. And by the time we caught it, it had already started to spread, though not aggressively."
He paused, clearly trying to collect his thoughts. "Laura had never suspected she had cancer. All she knew was that every time she got pregnant, something went wrong. And it wasn’t until the last miscarriage, when she felt something was different, that she pushed for more answers. You know how many women, especially in their 30s, assume they’re just unlucky? They don’t always realize that there can be an underlying medical reason that’s never been identified."
I could hear Giovanni's voice tremble, a rare show of vulnerability for him. "The worst part, was that Laura had gone through so many rounds of treatment, with doctors telling her to try again, that it was just bad luck, that it was nothing serious. She had been in and out of fertility clinics, each time more discouraged than the last. She had been through the heartbreak of multiple losses, and the emotional toll was becoming too much to bear. She never knew that the real issue was this silent illness growing inside her."
The emotion in Giovanni’s voice was evident. "We started Laura on treatment right away. Thankfully, we caught it early enough that we could begin a targeted therapy. But it was still a long and difficult road ahead for her. And the thing that keeps haunting me is that we could have caught it sooner. If only we had been more thorough from the start. If only we had connected the dots."
I could sense Giovanni’s regret, the weight of knowing that a few more tests earlier on might have spared Laura a great deal of pain and uncertainty. "But you didn’t know, Giovanni. None of us would have suspected it. It’s a rare case, and sometimes these things can hide for so long."
"True," he agreed, his voice softening. "But that doesn’t make it easier to accept. Laura had been through so much. The constant emotional upheaval of trying to conceive, followed by loss after loss, never understanding why. She had started to believe she was somehow broken, that her body was failing her. But it wasn’t her fault. It wasn’t her body that was at fault—it was the cancer. And I think that’s what frustrates me the most."
I paused before responding, wanting to offer some comfort. "I’m glad you found it, Giovanni," I said quietly. "It might be too late to undo all the pain she’s been through, but now she has a chance. And that’s the most important thing."
"Yes," Giovanni replied, his voice now steadier. "But it's not just about finding the illness—it’s about understanding the stories behind these patients. Laura's story is a reminder that sometimes, what we think we know about our patients isn’t the whole picture. We need to listen to them, to really hear them when they say something isn’t right. It’s the key to finding the hidden causes, the ones that don’t show up on our standard tests or procedures."
The silence that followed was thick with reflection. I could only imagine the emotional toll this case had taken on Giovanni and his team. The struggle of knowing that something could have been caught earlier, and how it might have changed the course of Laura’s life.
"I just wish we had found it sooner," Giovanni admitted. "I wish Laura had gotten the help she needed before it became so overwhelming. I think about all the other women out there who might be experiencing something similar, who might be suffering in silence. It's a reminder, that we can never be too careful. We can never stop looking for answers."
Giovanni had shared something deeply personal, a case that reminded him of the importance of thorough care, compassion, and the need to always look deeper when the answers aren’t obvious. Laura's story, though filled with pain, was a reminder to all of us that sometimes, the answers are hidden in the places we least expect.
As I sat back and reflected on Giovanni's words, I couldn’t help but feel a renewed sense of purpose in my own work. There were always stories behind the cases we see, and sometimes, it’s the most unexpected ones that have the most lasting impact.
Fatemah graduated with a Master's degree in Sexual and Reproductive Medicine from the University of South Wales, UK. Her research during her BSc focused on Brucellosis, where she earned top honors at her university for her work. During her MSc, she conducted research on Polycystic Ovary Syndrome (PCOS), further developing her expertise in reproductive health.
After gaining four years of experience in the IVF laboratory as a Senior Andrologist and Trainee Embryologist, Fatemah transitioned into veterinary services, working with the Jockey Club of Saudi Arabia as a Laboratory Assistant. During this time, Fatemah contributed to the care and medical reporting of racehorses and attended international horse auctions. Fatemah also worked closely with veterinarians in the medical care of horses during the Riyadh Racing Season.
Fatemah combines a deep passion for reproductive medicine with equine health and welfare expertise and is now a volunteer Female Cancer Correspondent at Cancer Care Parcel.
