如何以累積胚胎幫助AMH小於0.5的卵巢功能極低病人懷孕成功？

2020.07.24

 1    案例報告   如何以累積胚胎幫助AMH小於0.5的卵巢功能極低病人懷孕成功？

2  A case report: How to accumulate embryos to help patients with very low ovarian function with AMH less than 0.5 successful pregnancy?

3   蔡鋒博*,陳昭雯,林招彰,張月嬌,陳曉青,徐慧鈴,潘孟麗,張 琇媛,施俐君

Feng-Po Tsai, Chao-Wen Chen, Chao-Chang Lin, Yueh-Chiao Chang, Hsiao-Ching Chen, Hui-Ling Hsu, Meng-LI Pan, Hsiu-Yuan Chang, Li-Chun Shih

Poyuan Women Clinic IVF Centre, Changhua Taiwan

博元婦產科,不孕症試管嬰兒中心

 

4   Study Question:  AMH less than 0.5 is considered to be close to menopause.

 

 AMH is considered an indicator of the likelihood of pregnancy  

5    Study Design, Size, Duration: a case report in 2019

6  Materials, Setting, Methods: A 39-year-old woman conceived naturally and gave a

birth of a boy baby 6 years ago, who was diagnosed of Beckwith-Wiedemann syndrome

at the age of 6 months old. The genetic testing of her son revealed CDKN1C gene exon

1: c.187 T>C/WT and the mother was the carrier of CDKN1C gene exon 1: c.187

T>C/WT. She underwent controlled ovarian stimulation twice using antagonist protocol.

Transvaginal oocyte retrieval and intracytoplasmic sperm injection were performed.

Twenty-three blastocysts underwent biopsy and vitrification as well as the samples were

examined for PGD. The PGD revealed 8 embryos with wild-type CDKN1C gene and

the PGS further reported 6 euploidy embryos among them.

A 37-year-old infertility patient with 6 years of infertility

 

 The blood ovarian function of the medical center is less than 0.5

 

 3 IVF centers advised her to borrow eggs directly to make IVF

 

 The patient seeks to use his own egg as a test tube baby

 

 The patient refused to use the egg to make a test tube baby  

 

7   Main Results: Two wil  d-type CDKN1C gene and euploidy embryos were thawed and

transferred. One intrauterine pregnancy was achieved. The following prenatal

examination was normal. Amniocentesis revealed a normal karyotype fetus with

wild-type of CDKN1C gene exon 1: c.187 T>C using exon-wide sequencing. The

pregnancy is ongoing at the gestational age of 28 weeks.

After 6 times of egg retrieval, 9 eggs and 4 fertilized eggs were accumulated.

 

 The first time to take an egg, 1 fertilized egg, the second time can not get the egg, the third time to take an egg, 1 fertilization, the 4th egg, 2 fertilization, the 5th, the second egg, 2 Fertilization, the first 6 eggs, 3 fertilization, 1

 

 The patient implanted 2 embryos on the 3rd day of division, and the other 2 embryos were frozen.

 

 Pregnancy Successful Pregnancy Index 480.1

 

 Already born in January 2019, a male baby weighs 2,800 grams.  

 

8  Conclusion: Beckwith-Wiedemann syndrome is a rare imprinting gene disorder and

maternal CDKN1C mutation comprise only 5% of its etiology. We first report a

successful pregnancy with a wild-type fetus achieved by   PGD followed by frozen-thawed embryo transfer.

 

Conclusion: Very low ovarian function can still accumulate eggs or accumulate embryos to increase the likelihood of pregnancy

 

This case is the successful case of the IVF baby with the lowest ovarian function in this IVF center.  

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1. How to accumulate embryos to help patients with very low ovarian function with AMH less than 0.5 successful pregnancy?

 

3. If accumulating embryos to make IVF successful pregnancy depends on the following conditions: 1. The age of the patient, 2. The patient's will, 3. The patient's financial ability depends on

 

4. AMH less than 0.5 is considered to be close to menopause.

 

 AMH is considered an indicator of the likelihood of pregnancy

 

 It is recommended by three IVF centers to borrow eggs for IVF

 

5. A case report in 2019

 

6. A 37-year-old infertility patient with 6 years of infertility

 

 The blood ovarian function of the medical center is less than 0.5

 

 3 IVF centers advised her to borrow eggs directly to make IVF

 

 The patient seeks to use his own egg as a test tube baby

 

 The patient refused to use the egg to make a test tube baby

 

7. After 6 times of egg retrieval, 9 eggs and 4 fertilized eggs were accumulated.

 

 The first time to take an egg, 1 fertilized egg, the second time can not get the egg, the third time to take an egg, 1 fertilization, the 4th egg, 2 fertilization, the 5th, the second egg, 2 Fertilization, the first 6 eggs, 3 fertilization, 1

 

 The patient implanted 2 embryos on the 3rd day of division, and the other 2 embryos were frozen.

 

 Pregnancy Successful Pregnancy Index 480.1

 

 Already born in January 2019, a male baby weighs 2,800 grams.

 

8. Conclusions Very low ovarian function can still accumulate eggs or accumulate embryos to increase the likelihood of pregnancy

 

This case is the successful case of the IVF baby with the lowest ovarian function in this IVF center.

 

1. 如何以累積胚胎幫助AMH小於0.5的卵巢功能極低病人懷孕成功？

 

3. 如果累積胚胎來做試管嬰兒成功懷孕要看以下條件：1.病人的年紀、2.病人的意願、3.病人的經濟能力而定

 

4. AMH小於0.5被認為是接近停經狀態

 

 AMH被視為懷孕可能性的指標

 

 被3家試管嬰兒中心建議借卵子來做試管嬰兒

 

5. 一個案例報告在2019年

 

6. 一個37歲不孕症6年的不孕症病人

 

 醫學中心的抽血卵巢功能AMH小於0.5

 

 3家試管嬰兒中心建議她直接借卵子做試管嬰兒

 

 病人尋求使用自己的卵子做試管嬰兒

 

 病人拒絕借卵子做試管嬰兒

 

7. 經過6次取卵共累積了9顆卵子，4顆受精卵

 

 第一次取卵1顆受精卵1顆，第2次取不到卵子，第3次取卵1顆受精1顆，第4次取卵2顆受精1顆，第5次取卵2顆沒有受精，第6次取卵3顆受精1 顆

 

 病人植入第3天分裂期的胚胎2顆，其他2顆胚胎冷凍起來

 

 懷孕成功懷孕指數480.1

 

 已經在2019年1月生下一名男寶寶重量2800公克

 

8.結論 卵巢功能極低仍可以累積卵子或累積胚胎增加懷孕的可能性

 

本案例是本試管嬰兒中心遇過卵巢功能最低的試管嬰兒成功的個案