Advanced Maternal Age, Thrombocytopenia, and Male Factor Infertility

After 13 years of primary infertility, this couple arrived at Birla Fertility & IVF after experiencing repeated setbacks. The female partner's fertility journey was complicated by advanced maternal age, chronic thrombocytopenia, and hypothyroidism, while the male partner had male factor infertility. A previous IVF cycle at another centre had even been cancelled because her platelet count had fallen to critically low levels. With meticulous multidisciplinary planning, personalised IVF treatment, and close coordination with hematology specialists, the couple achieved pregnancy on their very first IVF attempt at our centre.

- Birla Fertility & IVF, Nagpur, (Dr. Pramod Madhukar Yerne)

Case Snapshot

Patient AgeFemale: 43 years | Male: Early 40s

ChallengesPrimary infertility for 13 years, advanced maternal age, chronic thrombocytopenia, hypothyroidism, previous cancelled IVF cycle, Rh-negative blood group, asthenoteratozoospermia, elevated sperm DNA fragmentation

TreatmentPersonalised ovarian stimulation under hematology supervision, ICSI with microfluidics-assisted sperm selection, blastocyst culture, frozen embryo transfer (FET)

OutcomeSuccessful pregnancy in the first IVF cycle at our centre, ongoing healthy twin pregnancy with stable maternal platelet counts

TimelineThirteen years of infertility followed by a personalised IVF cycle with multidisciplinary medical management.

Journey Timeline

1. Complex Challenges

2. Personalised Plans

3. Safe Retireval & Transfer

4. Guided Transfer

5. Successful Pregnancy

The Barriers They Faced

Advanced Maternal Age

At 43 years, age-related decline in fertility significantly reduced the chances of successful conception.

Chronic Thrombocytopenia

Persistently low platelet counts increased the risk of bleeding during ovarian stimulation and egg retrieval, requiring specialised medical supervision.

Previous IVF Cancellation

A planned IVF cycle at another centre had to be cancelled after the patient's platelet count dropped to 50,000/µL, preventing treatment from proceeding.

Additional Medical Conditions

Hypothyroidism and an Rh-negative blood group required careful optimisation before and during pregnancy.

Male Factor Infertility

The male partner had asthenoteratozoospermia with a DNA Fragmentation Index (DFI) of 18%, affecting sperm quality.

Need for Multidisciplinary Care

Safe fertility treatment required close collaboration between fertility specialists, embryologists, and hematologists.

Doctor's Quote

“The key was to tailor every aspect of care to this patient's unique needs, balancing safety, comfort, and clinical effectiveness.”

— Dr. Pramod Madhukar Yerne

The Treatment Plan that made the Difference

Multidisciplinary Treatment Planning

A coordinated care plan involving fertility specialists and hematologists was developed to safely manage thrombocytopenia throughout ovarian stimulation, egg retrieval, and pregnancy.

Personalised Ovarian Stimulation

Ovarian stimulation was completed under close medical supervision, allowing the safe retrieval of 15 mature (MII) oocytes without bleeding complications.

Advanced Sperm Selection and ICSI

To optimise fertilisation, ICSI was performed using microfluidics-assisted sperm selection, helping identify sperm with better functional quality.

Blastocyst Development and Cryopreservation

Several high-quality embryos developed successfully, with four Day 5 blastocysts cryopreserved for transfer.

Personalised Frozen Embryo Transfer

A carefully planned frozen embryo transfer (FET) was performed after optimising the uterine environment, ensuring the procedure was completed safely despite the patient's bleeding risk.

A Story of Safe, Personalised Fertility Care in a High-Risk Pregnancy

This case demonstrates that advanced maternal age, chronic thrombocytopenia, and male factor infertility do not necessarily prevent successful fertility treatment when managed through a multidisciplinary approach. By combining carefully monitored ovarian stimulation, microfluidics-assisted sperm selection, advanced embryology, and continuous hematology support, the clinical team safely navigated multiple medical challenges while achieving a successful twin pregnancy. It highlights the importance of personalised fertility care, expert coordination across specialties, and evidence-based treatment planning in helping even high-risk couples realise their dream of parenthood.

The Outcome

The personalised treatment approach resulted in:

Positive β-hCG of 4668, confirming successful implantation Pregnancy achieved in the first IVF cycle at Birla Fertility & IVF Ongoing healthy twin pregnancy Appropriate fetal growth at five months of gestation Stable maternal platelet counts throughout pregnancy with close monitoring