We would like to introduce you to a complex yet extremely inspiring clinical case from the practice of Dr. Olga Romanova — a reproductive endocrinologist.
This clinical example demonstrates the possibilities of modern reproductive medicine under conditions of diminished ovarian reserve and age-related factors, where every menstrual cycle is of particular value.
Patient Baseline Data
Diagnosis:
- secondary infertility;
- combined with male factor.
Hormonal indicators at the time of consultation:
- AMH — 0.7 ng/ml
- FSH — 12.8 IU/L
These indicators indicate a diminished ovarian reserve and a predicted limited ovarian response to standard stimulation.
Clinical rationale for the choice of tactics: In this case, the key constraint was time — given the woman’s reproductive age and the expected ovarian response.
Therefore, from the very beginning, we considered not a standard sequential approach, but a strategy that allows:
- maximizing the use of a single menstrual cycle;
- increasing the number of retrieved oocytes and embryos without losing months;
- improving the chances of obtaining a chromosomally healthy embryo.
Treatment Progress: DuoStim within a single cycle
First stimulation stage
- 7 eggs retrieved;
- 5 oocytes — mature;
- 4 embryos (blastocysts) formed after fertilization.
Second stimulation stage (within the same cycle)
- 12 eggs retrieved;
- 11 — mature;
- 6 more embryos obtained after fertilization.
Overall Result
PGT-A Results and Embryo Transfer
According to the results of the genetic analysis:
- only one embryo turned out to be euploid (chromosomally healthy);
- the embryo was of high morphological quality — 5BA;
- important clinical point: the euploid embryo was obtained specifically during the second stage of stimulation.
This specific embryo was transferred.
Clinical Outcome:
A clinical pregnancy occurred, which proceeded without complications and ended with the birth of a healthy, full-term baby girl.
This case clearly demonstrates that double stimulation (DuoStim) can be an effective and justified strategy:
- in women of advanced reproductive age;
- with diminished ovarian reserve;
- under conditions of limited time resources;
- when standard approaches do not allow for an optimal result.
About the author of the clinical case
Dr. Olga Romanova — fertility specialist, gynecologist-endocrinologist, Chief Physician of the Reprolife Medical Center. She has many years of experience in managing complex cases of infertility, specializes in personalized stimulation protocols, including DuoStim, working with low ovarian reserve, and women of advanced reproductive age.
