Fayola K J Fraser
The Trinidad and Tobago IVF and Fertility Centre is a gem in our country and region, that has facilitated countless families with the most precious gifts of new life. The centre, through its work over the past 20 years has achieved some major feats, including the birth of the first IVF baby in the English-speaking Caribbean in 1997 and producing approximately 3,000 babies since 2008.
Two of the trailblazing women behind this gruelling but deeply rewarding undertaking, who are making a notable impact on the lives of families in T&T and beyond, are Dr Catherine Minto-Bain, the medical director, OB-GYN and Fertility Specialist, and Sonja Mankee-Sookeram, Lead Embryologist.
Women, men, or couples who find themselves on the doorstep of T&T IVF, often seek help for various reasons. According to Minto-Bain, “People come to us saying they have trouble getting pregnant, or they are getting older and want to freeze their eggs in the current state, or they are single but want a baby and are looking for a donor sperm.” In some cases, as described by Minto-Bain, there are even extenuating medical circumstances, such as upcoming chemotherapy to treat breast cancer/testicular cancer.
These circumstances land women and men at T&T IVF to preserve their eggs or sperm to have the option of having a baby post-cancer treatment. Upon initial introduction to a new patient, the clinic offers an initial assessment to decipher the reasons for the patient not getting pregnant and sometimes offers an easy fix or other times refers the patient to the IVF process.
Part of the job of both Minto-Bain and Mankee-Sookeram is to educate and raise awareness around the viability of IVF, giving hope to those who often feel that all hope is lost.
In-vitro fertilisation, or IVF, has been commonly ignored as a viable option for family expansion in the Caribbean, or viewed with significant scepticism, where people refer to the product of the process as “a test tube baby”. Mankee-Sookeram describes IVF as a “three-phase process, where we first take eggs from the female and sperm from the male and put them together in one of two ways. Then we look for fertilisation and development of the eggs, and during those days we hope that it will become an embryo. Once we have the embryo, we place it in the uterus of the woman and wait for it to implant.”
In their dedication to excellence, these women have employed the most updated AI technology to “score” the embryo, essentially running a photo of the embryo taken from under a microscope in an AI programme to score the viability and genetics. However, even with the assistance of the most updated technology, the clinic has a pregnancy rate of approximately 60 per cent pregnancy after placing embryos in the woman. To patients, Minto-Bain said although they want to inspire hope, “we still don’t have a foolproof way of knowing which embryos will implant.”
The transparency and honesty of Minto-Bain’s expression of their implantation rate defines T&T IVF’s approach to their patients and is one of the clinic’s legacies. “We value the health of the baby and safety of the mother over pregnancy rates or commercial gain,” she says, which is also indicated by their reasonably scaled costs of IVF in comparison to other clinics internationally and even in the region. Minto-Bain’s leadership is characterised by dedication to patients and families, ensuring that every precaution and care is taken along the journey.
“I don’t sleep at night,” Mankee-Sookeram laughs, “especially when we have embryos in the incubators.” She described it as an honour and responsibility to be trusted with patients’ precious eggs, as “these belong to real people and we are tasked with caring for them.” They therefore ensure best practices in regulating the environment that the eggs and sperm are stored according to scientific standards. Mankee-Sookeram sleeps with her phone under her pillow, as if any of the standards are breached–for example, if the incubator drops below the regulated temperature–an alarm is set off and she hurries into the clinic regardless of the time of day or night.
Both women have been on countless journeys with families over the collective decades of their work at T&T IVF, and remember fondly the way that giving hope and giving life has shaped them.
Mankee-Sookeram who has loved science since she can remember herself, still recalls her first IVF pregnancy as one of the career-defining moments of her journey. She found herself ecstatic when the embryo was implanted and the patient became pregnant, and her work meant so much to the patient’s family, that they, mother and son, still visit her every year since. Minto-Bain, only a year after she had begun working in fertility, found herself going against the opinion of a patient’s “eminent” OB-GYN, who told her that she would never conceive, even with IVF. “I believed she had at least a five per cent chance, in a small window of time,” Minto-Bain said, remembering the firm stance she bravely took.
The patient conceived, and “at long last got her baby” who is now in his late teens. Minto-Bain recalled feeling overcome and overjoyed to see their transition from heartache caused by their struggles to the joy of becoming parents. This moment rooted her strongly in her self-conviction that she knew what she was doing, and convinced her to begin doing fertility full-time.
Although these women and their team are doing incredible work, and positioning T&T as a leader in the region for IVF and fertility, many women still feel intimidated to begin a journey of IVF.
According to the World Health Organization, one in six people globally are affected by infertility and struggle to get pregnant. Minto-Bain advised that women take solace in these statistics, and know that if conception is a struggle, you are not alone. She also encouraged women to get assessed as a first step, rather than making assumptions so they can understand their options.
The T&T IVF clinic does not cater to any demographic but supports women of all different ages, races and social classes. As a 20-women-strong staff, she said they are a community that bolsters all their patients during their respective journeys. Mankee-Sookeram’s main piece of advice is to not wait until it’s too late. She advised couples and women to not wait longer than six months of actively trying to conceive (for women under 35) and not longer than one year for women 35 and above before they seek support and assessment.
In the kitchen of the T&T IVF clinic, there is a board which holds cards and pictures from families whose babies have been made possible with the intervention of these incredible women. Catherine Minto-Bain and Sonja Mankee-Sookeram have worked tirelessly to not only give gifts of life to these families but do so with the utmost care and concern, ensuring that transparency and ethics are at the core of their ethos. Their legacy of excellence has propelled T&T to the forefront of IVF innovation in the Caribbean, and people from the Caribbean diaspora and even from the United States come to T&T to start their families. However, even with their expansion and uptick of foreign clients, Minto-Bain affirmed that they “remain passionate and committed to Trinidad & Tobago, and creating families for people in this country.”