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Tan Xiaojun
·Senior reproductive medicine expert
·Postdoctoral fellow at Peking University
·PhD candidate at Xiangya School of Medicine, Central South
University
·Master’s tutor at Central South University
· Master's degree candidate in reproductive
medicine at the University of South China
· Professional training at Huazhong University
of Science and Technology and Tongji
Hospital Reproductive Center
Expertise:
diagnosis and treatment of infertility, first/second/third generation IVF (including
egg/sperm donation), microsperm retrieval, embryo freezing and resuscitation, artificial
insemination (including husband's sperm and sperm donation), paternity testing, chromosomal
disease
diagnosis, high-throughput gene sequencing, endometrial receptivity gene testing and other
clinical
technology applications. Many of these technologies are at the leading level both domestically
and
internationally.
43 years old, AMH is only 0.8! Why did she succeed in the test tube once?
When 43 year old Ms. Li saw the strong fetal heartbeat with her own eyes through the B-ultrasound screen in the consultation room of Tulip International Reproductive Center, tears instantly blurred her eyes. Her AMH value is only 0.8 ng/mL, which is a clear signal of significant decline in ovarian reserve function, indicating that the hope of natural conception is extremely slim.
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When 43-year-old Ms. Li saw with her own eyes that powerful fetal heart beat through the B-ultrasound screen in the clinic of Tulip International Reproductive Center, tears blurred her eyes instantly. Her AMH value is only 0.8 ng/mL, which is a clear signal of "significant decline in ovarian reserve function", which means that the hope of natural pregnancy is extremely slim.
Her success is by no means accidental luck, but a victory forged by scientific planning, precise medical care and firm implementation.
For countless elderly women facing similar difficulties, Ms. Li's experience can be called a successful tutorial that can be copied and used for reference.
[1] fertile soil before sowing-3 months before pregnancy, systematically improve the quality of eggs.
This is the cornerstone of the whole campaign. The core challenge of childbearing at an advanced age is the sharp decline in the number of eggs and the cliff-like decline in quality. The decline of mitochondrial function (lack of energy) and the sharp increase of chromosome aneuploidy rate in egg cells directly determine whether healthy embryos can be formed in the future.
Therefore, systematic and multi-dimensional conditioning at least three months in advance is the key window period to improve the quality of eggs and lay a solid foundation for the test tube cycle.
Ms. Li's list of "keeping eggs":
1. Accurate supplement of core nutrients (under the guidance of doctors):
Coq 10: 400-600mg daily. The core function is to energize the mitochondria of the egg's "energy factory", improve the energy metabolism of the egg, and increase the fertilization rate and blastocyst formation rate. It is suggested to choose reduced coenzyme Q10 (panthenol) with higher bioavailability.
Active folic acid: 800μg per day. Direct participation in cell division and DNA synthesis is very important for egg maturation and early embryo development.
Vitamin D3: maintain an adequate level (blood concentration > 30ng/mL). A large number of studies have confirmed that vitamin D is positively related to ovarian function and follicular development.
DHEA: 50mg per day (this item must be used after being evaluated by a doctor). DHEA may improve the ovarian microenvironment and improve the responsiveness of follicles to ovulation-promoting drugs, especially for those with low ovarian reserve function.
2. Build a fertility-friendly lifestyle:
Optimization of diet structure: Strictly follow the "Mediterranean diet" mode to ensure the intake of high-quality protein (fish, poultry, eggs and bean products), a large number of fruits and vegetables and healthy fats (nuts and avocados). Strictly limit processed foods, trans fats and excessive sugar.
Regular and moderate exercise: do aerobic exercise (such as brisk walking, swimming and elliptical machine) for 30-45 minutes 3-5 times a week to improve pelvic blood flow and systemic metabolism. Avoid excessive strenuous exercise, so as not to cause stress to the body.
Sleep and stress management: ensure 7-8 hours of high-quality sleep every night. Through mindfulness meditation, yoga or psychological counseling, we can effectively manage long-term chronic stress, because it will directly interfere with the normal function of the reproductive axis.
[2] Tailor-made strategy-choose the most suitable scheme to promote emission.
For elderly women with decreased ovarian reserve function, the traditional "large dose" ovulation promotion scheme is often counterproductive-not only the response is poor, but also the quality of eggs may be further damaged. It is a key step to choose a ovulation promotion scheme that is highly matched with the ovarian state.
Strategies formulated by Tulip International Reproductive Center for Ms. Li;
1. Mini-IVF:
The traditional thinking of pursuing quantity was abandoned, and low-dose oral drugs (Letrozole) combined with low-dose injection drugs (Gn) were used for mild stimulation. Its goal is to obtain a small number (usually 1-4) of eggs with better development potential, while minimizing the burden on ovaries.
2. Embryo Banking:
This is the most effective way for the elderly patients with few eggs to achieve success. Due to the limited number of eggs obtained in a single cycle, the success rate of forced transplantation is not high. Therefore, experts from Tulip International Reproductive Center made a plan for Ms. Li to carry out 2-3 microstimulation cycles, and preserved the high-quality blastocysts obtained in each cycle through advanced vitrification technology.
3. Ms. Li's practice: She finally obtained two precious blastocysts which were proved to be aneuploid (normal chromosomes) by PGT-A gene detection through two microstimulation cycles. With these two "trump cards" in hand, the success rate of single transplantation has made a qualitative leap.
(3) Intensive cultivation before the decisive battle-meticulous preparation of endometrial environment
Having the best embryos is only half the battle. Whether this "soil" of endometrium is fertile and in the best "acceptance state" is the last and decisive step for successful implantation.
Trilogy of "intima optimization" before transplantation;
1, hysteroscopy (diagnostic gold standard):
Before the transplant, we arranged a hysteroscopy for Ms. Li. This is a "golden eye" for diagnosing tiny lesions in uterine cavity, which can intuitively find and deal with those "implantation killers" that are difficult to identify by B-ultrasound, such as endometrial polyps, mild intrauterine adhesions, chronic endometritis and so on.
Ms. Li's findings: The examination found mild chronic endometritis. After a period of targeted antibiotic treatment, her uterine microenvironment was thoroughly purified.
2. Individualized endometrial preparation plan:
Using the standard hormone replacement cycle (HRT) scheme, by accurately controlling the dosage and time of estrogen and progesterone, the physiological cycle closest to nature is simulated, and the intima thickness (9mm), morphology (clear three-line sign) and blood flow are ensured to reach the best state.
3, endometrial receptivity test (ERA) (if necessary):
For patients who have experienced repeated transplant failures, ERA detection can find the best individualized "implantation window" by analyzing the gene expression of endometrial tissue, and realize the perfect synchronization of embryo and endometrium.
Conclusion: The success of the aged test tube is the necessity of science and persistence.
It is no miracle that Ms. Li achieved a successful transplant under the extremely unfavorable conditions of 43 years old and AMH of only 0.8. It clearly reveals the core logic of the success of assisted pregnancy in the elderly:
1. Prospective preparation: at least 3 months in advance, scientifically "raise eggs" from multiple dimensions such as nutrition and lifestyle.
2. Individualization of the plan: abandon the blind pursuit of quantity, choose a mild ovulation promotion plan that is highly matched with your ovarian function, and patiently implement the strategy of "saving embryos".
3. Environment optimization: Before transplantation, the uterine environment should be systematically and carefully evaluated and treated, and no potential interference factors should be missed.
In Tulip International Reproductive Center, we have a team of experts from the top public hospitals in China, and we are committed to providing the most professional and personalized treatment plan for every elderly woman. Age is a challenge, but it is by no means the end. Scientific intervention, precise treatment and your unremitting persistence are the best combination to ignite the light of hope.
For fertility consultation in Kyrgyzstan, please contact your dedicated consultant
/Fertility Consultation /
Dr.Chan
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Common aliases:Kyrgyzstan Tulip Reproductive Center, Tulip IVF, Tulip Reproductive Center, Tulip Hospital, Kyrgyz Tulip Reproductive Center, Kyrgyz Tulip Hospital
