Dr. Le Xuan Nguyen, from the Center for Reproductive Assistance at Tam Anh General Hospital TP HCM (IVF Tam Anh TP HCM), reported on a patient, Kieu, who was 39 years old. She presented with reduced ovarian reserve (AMH), and an ultrasound at the start of her menstrual cycle showed 8-9 follicles. Dr. Nguyen initially planned ovarian stimulation with an appropriate dosage for Kieu, followed by a single egg retrieval and in vitro fertilization to create embryos. However, most of her follicles were empty and of poor quality.

This condition, known as empty follicle syndrome, occurs when follicles respond to stimulation and develop, but contain no oocytes or only poor-quality eggs that degenerate. Potential causes include advanced maternal age, hormonal imbalances, reproductive health conditions, or sometimes, the cause remains unknown.

Consequently, the doctor switched Kieu's treatment protocol to egg accumulation over multiple cycles. After two retrieval cycles, she yielded 7 mature eggs. However, the poor egg quality resulted in many embryos arresting early, with only two day 6 grade 3 embryos obtained. The doctor transferred both embryos simultaneously, leading to a biochemical pregnancy.

Following a one-year hiatus from treatment, Kieu and her husband embarked on their second in vitro fertilization cycle. Dr. Nguyen performed egg accumulation three times, collecting three eggs suitable for in vitro fertilization; the remaining eggs were either empty or degenerated. For this cycle, they opted for an advanced embryo culture package. Embryologists carefully selected high-quality sperm for intracytoplasmic sperm injection into each egg, enhancing the fertilization rate. The embryos were cultured in a time-lapse system integrated with artificial intelligence, featuring continuous camera monitoring. Ultimately, Kieu and her husband had one day 5 grade 3 embryo remaining.

Dr. Nguyen then developed an optimized uterine lining preparation protocol and transferred the single embryo into Kieu's uterus. The fetus is currently 32 weeks old and developing healthily.

Master Nguyen Ngoc Quynh, Head of the IVF Tam Anh TP HCM Lab, performs intracytoplasmic sperm injection. *Photo: Nguyen Trung*

At IVF Tam Anh TP HCM, approximately 60% of patients are older individuals with low ovarian reserve, poor egg quality, and complex medical conditions. Protocols such as egg and embryo accumulation over multiple cycles, combined with advanced embryo culture technology, have enabled thousands of patients to have their own children, even with a limited number of eggs and embryos.

Dr. Nguyen advises women to marry and complete their families before the age of 35. Couples who have been trying to conceive for one year without success should seek reproductive health examinations and early treatment to reduce time and cost. For women who are married but not yet ready for children, or who are single, egg freezing is an option to preserve fertility.

Hoai Thuong

*Patient's name has been changed