When the "low AMH" due to the urgent need for "egg inventory" encounters the "PGT-M" gene testing that must block family genetic diseases, this is undoubtedly one of the most difficult challenges in the field of assisted reproduction. Every egg carries great hope, and the loss of each link may turn the ultimate success into a bubble.

However, at the Tulip International Reproductive Center, we believe in the power of science to turn seemingly impossible tasks into reality. Today, we will conduct an in-depth review of a real case, revealing how precise clinical strategies and top-notch laboratory technology are perfectly combined to create textbook level "perfect scores" for families facing dual challenges.

Q1: What are the core difficulties for a patient with a low AMH value who needs to undergo PGT-M (Single Gene Disease Testing)?

A: This is a typical dilemma of "scarce raw materials" and "strict screening criteria".

Scarcity of raw materials (low AMH): AMH (anti Mullerian hormone) is a key indicator for evaluating ovarian reserve function. The AMH value as low as 0.7ng/mL means that the patient's basal follicle count is very small, and the number of eggs that can be obtained from a single ovulation induction is extremely limited. Every egg is precious.

Strict screening criteria (PGT-M): PGT-M (pre implantation monogenic disease testing) is used to screen healthy embryos that do not carry pathogenic genes. According to the laws of genetics, if both husband and wife are carriers of the same recessive genetic disease, theoretically they have a 1/4 chance of having a sick child, a 1/2 chance of being carriers, and only a 1/4 chance of being completely healthy. This means that even if successful blastocysts are obtained, on average, about 75% of embryos cannot be transplanted or are not preferred for transplantation after genetic testing.

Therefore, when these two challenges overlap, it means that we need to conduct strict "picking" when there are already very few "eggs", and the probability of obtaining a healthy embryo for transplantation will become very low mathematically.

Q2: Can you share a real case of successfully overcoming this dual challenge at the Tulip International Reproductive Center?

A: Of course. 37 year old Ms. Chen and her husband found us. The dilemma they are facing is precisely this:

Ovarian reserve diagnosis: Ms. Chen's AMH value is only 0.7 ng/mL, indicating low ovarian reserve function (DOR).

Genetic background: Both husband and wife are carriers of the Mediterranean anemia gene, which is a recessive genetic disease. Their previous pregnancy experience had to be terminated due to severe fetal poverty, so their only demand this time is to have a completely healthy baby through PGT-M technology.

Q3: Faced with such a tricky case, what was the final laboratory result?

A: With the close collaboration of the clinical and laboratory teams at Tulip International Reproductive Center, we have delivered a perfect answer for Ms. Chen's cycle:

Egg retrieval status: Through a precise ovulation induction program, we retrieved a total of 6 eggs, including 4 mature eggs and 2 immature eggs.

Successful in vitro maturation (IVM): Two immature eggs were cultured in vitro in the laboratory and eventually matured.

Fertilization rate: All 6 mature eggs were successfully fertilized using ICSI technology.

Embryo formation rate: Six fertilized eggs successfully developed to the blastocyst stage under careful cultivation in the laboratory.

High quality blastocyst rate: The final 6 blastocysts formed are rated as high-quality blastocysts that can be used for biopsy and freezing.

This result means that we have maximized the use of every precious egg for Ms. Chen, without any loss at any critical stage, and have reserved the maximum possible number of "candidate embryos" for subsequent PGT-M gene testing, greatly enhancing her hope of ultimately obtaining a healthy baby.

Q4: What did the clinical and laboratory teams at Tulip International Reproductive Center do behind creating this' miracle '?

A: This is not a miracle, but a manifestation of science, precision, and ultimate craftsmanship.

1. Clinical end: Tailored "mild stimulation+precise regulation" plan

We did not use high-dose drugs for strong stimulation, but developed a mild stimulation plan for Ms. Chen with PPOS (ovulation induction under high progesterone state) as the core.

Advantages of the plan: This plan uses oral progesterone to prevent premature ovulation of follicles, while using low-dose ovulation inducing drugs, aiming to obtain fewer but better quality eggs, which is very suitable for patients with low ovarian reserve function.

Precise regulation: Throughout the entire cycle, we closely monitor hormone levels and follicle development, dynamically adjust the dosage and type of drugs (such as nalphine, fertility supplements, etc.), and add antagonists (such as Si Zekai) at the most appropriate time (trigger day) to ensure that the final maturation of the egg is triggered at the optimal time.

2. Laboratory end: True "hardcore" strength

IVM technology turns waste into treasure: For DOR patients, every egg cannot be given up. Our embryologists have successfully 'rescued' two immature eggs through advanced in vitro maturation (IVM) techniques. In the context of a conventional IVM technology maturity rate of about 60%, a 100% success rate reflects the top level of the laboratory.

ICSI technology ensures high fertilization rate: For precious eggs that require PGT, we use the second-generation IVF technology (ICSI), where experienced embryologists select the best shaped and energetic sperm under a microscope and inject them directly into the egg to ensure a foolproof fertilization process.

Top notch blastocyst culture system: capable of 100% culturing 6 fertilized eggs into blastocysts, which directly reflects that the culture medium system, incubator environment (temperature, humidity, gas concentration), and quality control system of Tulip International Reproductive Center Embryo Laboratory have reached the highest industry standards.

Q5: How should ordinary readers understand the concepts of "low AMH" and "premature ovarian failure"?

A: These are two closely related but not completely equivalent concepts.

Low AMH: AMH is a hormone secreted by small follicles in the ovary, which can be understood as an indicator reflecting the "inventory" of the ovary. Low AMH means that there may be fewer eggs left in the ovaries compared to peers, which is an important signal that ovarian function is beginning to decline.

Premature ovarian failure (POI): refers to the decline in ovarian function in women before the age of 40. It not only manifests as a sharp decrease in the number of eggs (extremely low AMH), but also includes the loss of ovarian estrogen secretion ability, resulting in a series of menopausal symptoms such as menstrual disorders, amenorrhea, hot flashes, night sweats, etc.

The reasons for ovarian dysfunction are complex and may be related to various factors such as genetics, autoimmune diseases, radiation, chemotherapy, or surgical injuries, as well as unhealthy lifestyles.

For patients like Ms. Chen who face the dual challenges of low AMH and PGT-M, what we pursue is never simply the number of retrieved eggs, but the ultimate efficiency and quality. This case of 100% fertilization rate and 100% blastocyst rate perfectly embodies the therapeutic philosophy of "less but better" at Tulip International Reproductive Center - to maximize the potential of every precious egg through precise clinical protocols and top-notch laboratory technology. This is our solemn commitment to the hopes of every family.

For fertility consultation in Kyrgyzstan, please contact your dedicated consultant

/Fertility Consultation /

Dr.Chan

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