Healthy Live Birth at 40 After Two Failed IVF Cycles

Living in the United Kingdom, this 40-year-old woman had already undergone two unsuccessful IVF cycles before visiting Birla Fertility & IVF, Perinthalmanna. She had secondary infertility, advanced maternal age and reduced ovarian reserve, with an AMH of 1.0 ng/mL. Her male partner had normal semen parameters. Treatment was planned around her expected ovarian response, with individualised stimulation followed by ICSI and extended embryo culture. The cycle resulted in good-quality blastocysts, a successful pregnancy and the birth of a healthy baby boy.

- Birla Fertility & IVF, Perinthalmanna, (Dr. Amrutha C. V.)

Case Snapshot

Patient AgeFemale: 40 years

ChallengesAdvanced maternal age, secondary infertility, AMH 1.0 ng/mL, reduced ovarian reserve and two previous failed IVF cycles

TreatmentIndividualised ovarian stimulation, egg retrieval, ICSI, blastocyst culture and embryo transfer using a hyaluronan-enriched transfer medium

OutcomeSuccessful pregnancy followed by the birth of a healthy baby boy

TimelineTwo unsuccessful IVF cycles in the UK before personalised treatment at Birla Fertility & IVF

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 40, age-related changes in ovarian response and egg quality were important considerations while planning treatment.

Reduced Ovarian Reserve

An AMH of 1.0 ng/mL suggested a reduced ovarian reserve and the likelihood of a limited response to stimulation.

Previous IVF Failure

Two earlier IVF cycles in the UK had not resulted in pregnancy, making reassessment of the current ovarian response essential.

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. Amrutha C. V.

The Treatment Plan that made the Difference

Individualised Ovarian Stimulation

The stimulation protocol was tailored according to the patient's age, ovarian reserve and anticipated response.

ICSI Using Six Mature Oocytes

Six mature oocytes were available for ICSI during the treatment cycle.

Extended Blastocyst Culture

The embryos were cultured further to assess development through the blastocyst stage.

Blastocyst Selection and Transfer

Good-quality 4AA and 4AB blastocysts were selected for transfer. A hyaluronan-enriched embryo-transfer medium was used as part of the transfer protocol.

A Story of Personalisation at Every Step

At 40, with reduced ovarian reserve and two previous IVF failures, treatment needed to reflect the patient’s current ovarian response. Rather than focusing only on egg numbers, the plan centred on obtaining mature oocytes, assessing embryo development carefully and making each stage of the cycle count.

The Outcome

The pregnancy progressed without major complications, culminating in the birth of a healthy baby boy.

The case demonstrates that advanced maternal age and reduced ovarian reserve do not automatically rule out a successful IVF outcome.