[Case] IVF at 42 with low AMH: advanced maternal age third-generation IVF — one

When trying to conceive at 42 with advanced maternal age IVF, AMH 0.89 (often called low AMH) is not uncommon. In this case, two overseas IVF egg retrievals both failed screening (aneuploidy / no transferable embryos). After switching to Dan Ruo IVF Clinic in Bangkok, Thailand, a single egg retrieval with third-generation IVF (PGT) yielded a euploid blastocyst, and one transfer led to a successful pregnancy. For women of advanced maternal age, what matters more than persisting blindly is breaking through with a strong laboratory and a personalized protocol.

Every embryo is a family’s hope and dream

The label of advanced maternal age fertility sits like an invisible heavy door, pressing down on a woman’s marriage, relatives, and her own expectations. Ms. L sat in the long corridor outside a clinic in Country M, holding a thin lab report that showed none had passed screening!

She recalled the video consult earlier that year; those words still echoed: “Age is the key—you need to act quickly.”

In Bangkok in June, the air carried the clear fragrance of white orchids woven with summer humidity. After the daytime heat and steam eased, the glass façade of Dan Ruo IVF Clinic caught the molten-gold afterglow of sunset—and Ms. L’s silhouette with it.

Prior IVF history: two setbacks across the ocean

Two overseas IVF reports—6 eggs and 9 eggs—both failed screening.

September 2025 (Country M): Microdose Flare protocol; 6 eggs retrieved, of which 5 were mature; 1 sent for testing; failed screening.

December 2025 (Country M): Switched to a GnRH antagonist protocol without oral contraceptive priming; retrieval on 17 December, 9 eggs; consult notes recorded 8 mature; 3 sent for testing; failed screening.

Advanced maternal age IVF cycle in Bangkok: the third attempt at 42

Baseline

Age: 42

AMH: 0.89 ng/mL (diminished reserve; often called low AMH)

Menstrual cycle: 28–30 days

Antral follicles: left 2–3, right 4

Stimulation protocol

Dan Ruo IVF Clinic used a PPOS protocol combining HMG + medroxyprogesterone acetate + clomiphene (CC).

HMG was adjusted between 150 and 225 IU; around trigger day, levels were about 1501 pg/mL.

Retrieval and lab course

19 June 2026 (retrieval): 4 eggs retrieved. Of these, 3 were MII mature eggs; 1 was abnormal.

Day 1

ICSI used thawed sperm. D1 showed 2 eggs were MII mature and normally fertilized; 1 was abnormal. Result: 2PN ×2, 3PN ×1.

Day 2 - Day 3

Embryo 1 (2PN): reached 10 cells on Day 3

Embryo 2 (3PN): continued development

Day 5 - Day 6

Time showed its selecting hand: cells at the blastomere stage embraced, fused, and expanded, and finally on Day 5 (D5) and Day 6 (D6) became two crystal-clear blastocysts that were cryopreserved:

Embryo 1: Day 6, 5BA

Embryo 2: Day 6, 4BB

Third-generation IVF (PGT) screening and outcome

More than ten days later, the third-generation IVF (PGT) report came out:

Blastocyst 1 (5BA): euploid, transferable (XY)—passed screening

Blastocyst 2 (4BB): trisomy +13, +15—not transferable.

Successful transfer and pregnancy test — hCG 830.03 IU/L

Three-cycle comparison: overseas IVF vs IVF in Thailand

September 2025, Country M: Microdose Flare protocol; 6 eggs retrieved; 1 sent for testing; failed screening.

December 2025, Country M: GnRH antagonist protocol; 9 eggs retrieved; 3 sent for testing; failed screening.

June 2026, Dan Ruo IVF Clinic (Bangkok): HMG + medroxyprogesterone acetate + CC combination; 4 eggs retrieved; 2 sent for testing; 1 passed third-generation IVF (PGT) screening and was transferred.

Looking back on this winding path, the decisive gap was the outcome: two egg retrievals across the ocean cost great effort yet twice ended in the impasse of “no transferable embryo”; switching to Dan Ruo IVF Clinic, in just one cycle and one retrieval, produced a screened blastocyst.

For advanced maternal age IVF families, what decides the outcome has never been how many eggs are retrieved, but lab strength that settles the matter and precise protocol design—Dan Ruo IVF Clinic, with concrete results, broke a long stretch of travel and waiting and let hope land in one go.

Context and data: the statistics facing advanced maternal age IVF

In advanced maternal age IVF, aneuploidy pressure from age often matters more than “how many eggs are retrieved” in determining whether a transferable embryo exists.

Figure: median of 2 blastocysts at age 42

(A) Mean, median, minimum, and maximum number of biopsied blastocysts by patient age. Only in younger patients did the median number of biopsied blastocysts exceed 5.

(B) Blastocyst counts in individual cases. In 50% of cases, the number of blastocysts available for biopsy was 3 or fewer;

Figure: aneuploidy rate near 75% at age 42

(A) The complexity of aneuploidy that occurs is influenced by age. Increasing age not only raises the proportion of aneuploid embryos, but also raises the proportion of embryos with more than one aneuploid chromosome.

(B) Across the reproductive lifespan, the ratio of trisomy to monosomy is close to 1, and absolute variation is low at all ages. There are, however, differences between younger and older patients: younger patients show a higher share of monosomy, while older patients show a higher share of trisomy.

She sat on a balcony by the Suzhou River, watching the water flow slowly by. The sunset plated the river surface in warm, glittering orange, like distant, lingering Sanskrit chanting, letting her set down all worry and anxiety in that moment. She rested a hand on her abdomen and felt the joy of life.

This article is a de-identified case share. Outcomes vary by individual; it does not constitute a promise of efficacy and does not replace in-person medical advice.