Dr. Tran Ngoc Van Anh, from the Center for Reproductive Assistance at Tam Anh General Hospital - District 8, diagnosed Tam with polycystic ovary syndrome (PCOS), an endocrine disorder that disrupts ovulation. Tam, 29, had been struggling with infertility for 7 years, marked by prolonged menstrual irregularities. Ultrasound examinations revealed numerous small follicles in her ovaries, combined with her history of sparse periods, indicating chronic anovulation that made natural conception difficult. Additionally, her uterine lining was abnormally thick.

Dr. Van Anh explained that in individuals with anovulation, the body lacks progesterone, a hormone crucial for balancing estrogen. This hormonal imbalance leads to continuous endometrial proliferation, resulting in a thick but unstable lining that impedes embryo implantation. To address this, Tam underwent ovarian stimulation for in vitro fertilization. Doctors successfully retrieved 25 oocytes, fertilized them, and cultured 16 day-5 embryos, most of which were of good quality.

Further assessment revealed complications that could hinder embryo implantation. An endometrial biopsy, performed on the day of oocyte retrieval, confirmed benign endometrial hyperplasia. Uterine cavity evaluation also showed a non-uniform endometrium with scattered small polyps. Nearly 2 months later, Tam's health stabilized, and her endometrium was prepared for frozen embryo transfer. For the initial attempt, doctors used hormone-suppressing medication to control her hormonal axis, followed by estrogen supplementation to thicken the endometrium. However, after 7 days, her uterine lining thickened to 14 mm, prompting doctors to cancel the cycle due to suboptimal conditions.

In the subsequent cycle, doctors implemented a revised strategy. Instead of solely supplementing hormones, Tam received medication that mildly stimulated her ovaries while simultaneously inhibiting estrogen's effect on the endometrium. This approach allowed the lining to develop slowly but more uniformly and stably. When her endometrium reached 7,5 mm with a suitable structure, doctors transferred one good quality day-5 embryo into her uterus. Tam conceived on her first embryo transfer attempt and is currently 12 weeks pregnant.

Dr. Van Anh performing oocyte retrieval for a patient. Photo: Tam Anh General Hospital - District 8

Polycystic ovary syndrome is a common endocrine disorder affecting women of reproductive age. Its manifestations include ovulatory dysfunction, irregular periods, and the presence of numerous small follicles in the ovaries. PCOS can cause infertility due to irregular ovulation and hormonal imbalance, leading to prolonged estrogen dominance that affects the uterine lining.

Dr. Van Anh advises women to seek medical attention if they experience delayed or abnormally sparse periods. Delaying treatment for many years, as Tam did, can lead to endometrial hyperplasia and an increased risk of polyps, making the treatment process more complex.

Dinh Lam

*Character's name has been changed