After 6 years of having her first child, Huong and her husband decided to have another, but despite consulting many places and trying both traditional and Western medicine, she could not conceive. She underwent in vitro fertilization (IVF) twice at another hospital, conceiving twins and then triplets, but both pregnancies ended in miscarriage in the early weeks.

Early last year, Huong, then 42, visited the Center for Reproductive Assistance at Tam Anh General Hospital Ho Chi Minh City (IVF Tam Anh TP HCM). Doctor Le Xuan Nguyen diagnosed her with polycystic ovary syndrome, while her husband had abnormal sperm morphology, necessitating IVF treatment to conceive.

Doctor Le Xuan Nguyen performs oocyte retrieval for Huong. Photo: IVF Tam Anh

Doctors retrieved 17 oocytes from Huong. An embryologist washed and filtered the husband's semen sample, selecting sperm with the best morphology and motility under a 400-times magnified microscope. The in vitro fertilization and culture process resulted in 6 day-5 embryos.

Given Huong's advanced age and history of multiple miscarriages, doctors recommended preimplantation genetic testing for aneuploidy (PGT-A) before embryo transfer. Of the 6 embryos, only one was confirmed to be normal; the remaining 5 showed high mosaicism, meaning they contained both normal and abnormal cells, and thus had to be discarded.

Doctors also discovered Huong had endometritis and endometriosis. She underwent treatment for the inflammation for two weeks. Once the inflammation improved and her uterine lining reached an ideal thickness, doctors transferred the single viable embryo into her uterus, and Huong successfully became pregnant.

Master of Science, Doctor, Level II Specialist Le Thanh Hung, Deputy Head of Obstetrics Department, Obstetrics and Gynecology Center, Tam Anh General Hospital Ho Chi Minh City (right), and his team perform a cesarean section for Huong. Photo: Nguyet Nhi

As an older pregnant woman with chronic hepatitis B and gestational diabetes, Huong received close monitoring from obstetricians, endocrinologists, and hepatobiliary specialists. Doctors prepared a protocol for immediate serum and vaccine injections after birth to prevent the risk of hepatitis B transmission from mother to child.

Throughout her pregnancy, Huong faced repeated risks of miscarriage and premature birth, requiring emergency hospitalization. Master of Science, Doctor, Level II Specialist Le Thanh Hung, Deputy Head of Obstetrics Department at the Obstetrics and Gynecology Center, performed a timely cervical cerclage to preserve the pregnancy and enhanced cervical protection with a pessary. Huong was advised to limit physical activity and rest extensively to maintain the pregnancy.

Doctors prescribed tocolytics to sustain the fetus day by day and prepared for fetal lung maturation medication in case of progressive preterm birth risk. Thanks to these interventions, Huong successfully carried the pregnancy to 38 weeks, delivering her daughter via planned cesarean section. Her healthy baby girl was born weighing 3,3 kg.

Doctor Le Xuan Nguyen visits Huong's newborn daughter. Photo: Nguyet Nhi

According to Doctor Nguyen, older women face a higher risk of miscarriage due to declining oocyte quality and an increased rate of chromosomal abnormalities in embryos. Many natural or assisted pregnancies fail because embryos are not robust enough, leading to early developmental arrest.

At IVF Tam Anh, embryo screening is considered an optimal method for enhancing embryo quality, increasing pregnancy rates, and ensuring healthy births, especially for older patients or those with multiple previous failures. The most common technique is PGT-A, which analyzes embryo chromosomes after a day-5 biopsy, helping to identify and remove aneuploid embryos and select normal ones for uterine transfer.

Furthermore, the uterine lining plays a crucial role in implantation and pregnancy maintenance. Therefore, before embryo transfer, patients undergo comprehensive examinations to address any abnormalities such as endometritis, endometriosis, polyps, fibroids, or excessively thin uterine lining. This optimizes the uterine environment, improving the chances of a successful pregnancy and a healthy baby.

Nguyet Nhi

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