Bangalore, May 11: Ms. Ranjana (29) and her husband (35) had been trying to conceive for five years. Despite regular menstrual cycles, she was diagnosed with low ovarian reserve, a condition where the number and quality of eggs in the ovaries are reduced.
According to multiple Indian clinical studies, approximately 30–40% of women may experience a low ovarian reserve. A study conducted at JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research) reported that 40% of infertile women under 35 showed poor ovarian reserve.
Her Anti-Müllerian Hormone (AMH) was 1.12, that is a blood test which indicates how many eggs a woman has left. Her husband was diagnosed with asthenoteratozoospermia, meaning his sperm had poor movement and abnormal shape, along with a borderline DNA Fragmentation Index (DFI) approximately 32 % sperm DNA damage.
Before coming to Milann Fertility Hospital, Bengaluru, the couple had undergone four failed IUI (Intrauterine Insemination) cycles and one failed IVF (In Vitro Fertilisation) cycle at another fertility clinic. The previous IVF cycle resulted in an asynchronous follicular response, and although good-grade embryos were created, the fresh embryo transfer did not succeed.
At Milann, under the guidance of Ms Vidyashree M C, Embryologist, the treatment was focused on correcting both male and female factors.
Ms Vidyashree M C, Embryologist, Milann Fertility Hospital, Bengaluru, explained, “The husband was evaluated by an andrologist, started on treatment, and his repeat DFI improved from 32% to 21%. Whereas, Ms Ranjana was placed on supplements such as folic acid, CoQ10 and Vitamin D, followed by pretreatment with oral contraceptive pills (OCPs) not for contraception, but to synchronise follicle development before IVF. A new IVF cycle was planned using an antagonist protocol, that is a stimulation method which prevents premature ovulation.”
On the third day, her Antral Follicle Count (AFC) was 15, suggesting a better-than-expected response. She received injections of recombinant FSH and HMG, hormones used to stimulate the ovaries to produce multiple eggs. The cycle resulted in 14 oocytes, of which 12 were mature and 10 were fertilised. Ultimately, ten high-quality blastocysts were formed with embryos with higher pregnancy potential on the fifth day.
For the Frozen Embryo Transfer (FET) cycle, the team chose a mild stimulation approach to prepare the uterus. To enhance receptivity, intrauterine PRP (Platelet-Rich Plasma) installation was performed, an innovative method using the patient’s own blood components to improve the uterine lining. The endometrial thickness (ET) reached a favourable 9 mm. A single top-quality blastocyst was transferred, and the couple resulted in a positive pregnancy. Ranjana eventually delivered a healthy baby girl at 38 weeks.
Ms Vidyashree, added, “This case promotes how personalised treatment, correction of male-factor issues, advanced embryo culture, and endometrial optimisation strategies like PRP can dramatically improve success rates for couples struggling with low ovarian reserve and sperm abnormalities.”
Milann’s multidisciplinary initiative always believes not just in conception, but a healthy full-term delivery.
Ms. Ranjana shared, “Milann and Ms. Vidyashree have truly helped us achieve our dream of becoming parents. Their detailed evaluation of our health and personalised treatment plan supported us throughout the journey, from conception to a healthy delivery
