Self-cycle IVF results in healthy twin boys for a woman with poor ovarian reverse
A couple came to Nova Fertility Centre, Kolkata with a 10-year of being childless. The couples were professional actors with hectic schedules.
At the time of their first visit to Nova IVF the wife aged 36 years and was diagnosed with a very poor ovarian reserve with an egg count of only 3-4 on both sides together, and her husband was diagnosed with a slight drop in sperm count and motility.
What does poor or low ovarian reserve mean?
Poor or low ovarian reserve refers to a clinical condition in which a woman's ovaries do not contain as many eggs as expected for her age. Ovarian reserve affects the ability to conceive and deliver a live birth.
One of the most powerful factors in ovarian reserve is a woman's age. All women are born with a finite number of eggs, usually around one million. When puberty is reached, the number of eggs is reduced to around 500,000. From puberty (around age 12) to menopause (around age 51+), there is a gradual depletion of the number and quality of eggs in the ovaries and therefore a decrease in ovarian reserve and reproductive potential. The rate of egg loss from the ovary is genetically predetermined. Some women will experience a significant decrease in egg count in their 40s, while others will experience it much earlier. Women who experience premature decline are considered to have low or poor ovarian reserve.
There are other causes of poor ovarian reserve, such as the ovary being damaged or destroyed by a disease process such as endometriosis, ovarian tumors, or autoimmune disorders. Other factors may include exposure to certain chemotherapy agents or radiation therapy, ovarian surgery, and pelvic infection.
Based on their previous history and diagnostic results at Nova IVF Kolkata, Dr. Aindri, the fertility specialist provided the couple options and possibilities of success with choices starting from intrauterine insemination (IUI)/in vitro fertilisation (IVF)/egg donation, etc.
The couple wanted to try a few cycles of IUI initially because they were not willing for use of donor eggs and the consultant went ahead with the treatment after the couples took an informed decision.
What is IUI?
It is also known as alternative insemination or artificial insemination. Intrauterine insemination (IUI) involves injecting the sperm directly into the uterus while you are ovulating, which helps the sperm get closer to the egg. This reduces the time and distance the sperm must travel, making it easier to fertilise the egg.
The couple tried IUI twice in Nova IVF, but it wasn’t a success. At this point, the couple temporarily stopped taking medication.
Two years later, they showed up once more intending to undergo IVF and approached Nova Fertility centre to continue self-cycle IVF for their fertility problem.
When should self-cycle IVF be considered?
Self-cycle IVF could be a good option for couples if they have had the following health problems:
- Fallopian tubes have been damaged, blocked or removed
- Low or poor ovarian reserve
- Uterine fibroids
- Poor sperm quality (motility, count, etc.) or male infertility.
How is IVF performed?
To perform IVF, ovarian production is stimulated through injectable or oral medication. The objective is to produce several follicles, which will be aspirated via transvaginal ultrasonography to capture the eggs that will receive the sperm. The embryo is later transferred to a woman's uterus through a catheter after it has reached the correct stage of development, which takes 5 days (at the blastocyst stage). The whole IVF treatment lasts an average of 25 days.
Anti-mullerian hormone (AMH, a marker used to assess a woman's ovarian reserve and thus to evaluate a woman’s fertility status at a given time) was less than 1.2, but the couple was adamant about trying with self-cycle IVF.
Dr. Aindri Sanyal, the fertility specialist at Nova IVF Fertility centre, Kolkata, counselled the couple regarding the low chance of success and high risk of miscarriage in case of the couple attempting to conceive using self-cycle IVF. She had suffered recurrent pregnancy loss and had known that IVF was the only option safely growing the family. Therefore, the couple decides to pursue self-cycle IVF.
In line with their expectations, 3 eggs were successfully extracted from the IVF cycle, where only 2 of them were mature and fertilised. On day 5, 2 blastocysts of high quality were implanted in the uterus of the lady.
The pregnancy test was positive 10 days later, and a transvaginal ultrasound (a type of ultrasound used to examine a woman's genital organs, including the uterus, ovaries, cervix and vagina) performed, 3 weeks later revealed two healthy live foetus. And now, she is the mother of twin healthy boys at 36 weeks after an uneventful pregnancy. This treatment shows evidence that patients with low AMH do not always have to choose egg donation. Nova IVF can maximise the chance of a healthy pregnancy through the advanced IVF lab, expert IVF specialists, trained embryologists and international protocols that we follow.
Nova IVF has delivered over 50,000+ successful IVF pregnancies across India.