Tests at the Center for Reproductive Assistance, Tam Anh General Hospital TP HCM (IVF Tam Anh TP HCM), showed that Thuy and her husband had normal reproductive health. Thuy had a good ovarian reserve index (AMH 3,1 ng/mL) and two open fallopian tubes, while her husband had good sperm. Despite these findings, they faced 6 years of infertility and decided to undergo in vitro fertilization (IVF).

Doctor of First Degree Specialization Nguyen Thi Thach Thao stimulated Thuy's ovaries, successfully retrieving 11 mature oocytes. From these, 10 day 3 embryos were fertilized. All embryos were then cultured in a time-lapse system integrated with artificial intelligence (AI), developing into 6 good quality day 5 embryos.

The time-lapse embryo culture system integrated with artificial intelligence (AI) in an ISO 5 lab. *IVF Tam Anh*

To ensure an optimal uterine environment for embryo implantation, Doctor Thao performed a detailed ultrasound examination of Thuy's uterus. During this, she discovered Thuy had endometriosis and focal endometrial hyperplasia. Endometriosis is a condition where tissues similar to the uterine lining grow outside the uterus. Under the influence of cyclical hormones, these lesions can cause chronic inflammatory reactions and localized bleeding, potentially leading to scar tissue or adhesions over time, which impedes embryo implantation.

Thuy received hormone suppression treatment for four weeks before her first embryo transfer, but the pregnancy stopped developing early. Doctor Thao then continued hormone suppression treatment to further optimize the uterine environment. This subsequent attempt saw the embryo implant successfully and develop healthily. At 39 weeks of pregnancy, Thuy gave birth to a daughter weighing 2,9 kg.

Doctor Thach Thao with Thuy and her husband, alongside their newborn daughter at Tam Anh General Hospital TP HCM. *Nguyet Nhi*

According to Doctor Thao, unexplained infertility accounts for approximately 30% of couples seeking treatment at IVF Tam Anh TP HCM. She notes that subtle uterine lesions, endometriosis, or abnormalities related to fertilization and embryo implantation may not be evident through routine examinations, leading to an initial diagnosis of "unexplained" infertility.

In such complex cases, doctors may employ advanced diagnostic measures, including: saline infusion sonography, hysteroscopy, and genetic testing. Detecting and addressing any abnormalities helps determine the appropriate treatment approach before proceeding with further assisted reproductive methods or embryo transfer, thereby increasing the chances of a successful pregnancy.

Nguyet Nhi