[Thai Darnuo Success Story] From 'Empty Follicles' in the US to a 4AA Blastocyst at Darnuo

Basic Information: Female age: 34; AMH: 0.22–0.8 ng/mL (consistently low ovarian reserve across multiple tests); Obstetric history: one naturally conceived child; Menstrual cycle: regular (26–28 days); Past medical history/allergies/family genetic disorders: none. Overseas Challenge: The shadow of 'empty follicles'.

[图片:https://cdn.yun.sooce.cn/6/59417/jpg/1748417032291c4ca4238a0b923820dcc509a6f75849b.jpg?version=0][Photo: Patient's initial consultation at Darnuo Reproductive Hospital]

Basic Information

Female age: 34

AMH: 0.22–0.8 ng/mL (multiple tests confirmed consistently low ovarian reserve)

Obstetric history: one naturally conceived child

Menstrual cycle: regular (26–28 days)

Past medical history/allergies/family genetic disorders: none

Overseas Challenge: The shadow of 'empty follicles'

[图片:https://cdn.yun.sooce.cn/6/59417/png/1748417032416318635081423d629773e85a20d057e24.png?version=1748417036][Photo: US clinic ultrasound report showing 12 antral follicles]

Due to her very low AMH (0.22–0.8 ng/mL) and desire for a second child, she pursued IVF in the United States. Her first monitoring scan revealed '12 antral follicles.' The U.S. physician’s protocol was as follows:

[图片:https://cdn.yun.sooce.cn/6/59417/png/17484170324181d6299d4c0b15fb4edac5525c03aa30e.png?version=1748417037][Photo: U.S. clinic’s stimulation protocol document]

High-dose Gonal-F: 300–375 IU/day × over 10 days

High-dose combined oral ovulation induction: Clomid 100 mg/day + Tamoxifen 40 mg/day (Days 1–5)

Although this protocol appeared highly aggressive, the outcome was deeply disappointing—'only 3 oocytes retrieved, all empty.'

[图片:https://cdn.yun.sooce.cn/6/59417/jpg/1748417032419205174d21a9e085bece3a75b0f63490f.jpg?version=1748417036][Photo: Lab report from U.S. clinic indicating zero mature oocytes]

Darnuo’s Breakthrough: A turnaround journey with AMH ≈ 0.5

[图片:https://cdn.yun.sooce.cn/6/59417/png/1748417032418baf78d03cd2d52699ada658e78ce7e08.png?version=1748417037][Photo: Darnuo’s personalized treatment plan summary]

Initial assessment at Darnuo in February 2025

The physician precisely identified the core issue: 'Your AFC is not poor—the fundamental challenge lies in low oocyte maturation rate.'

Dr. Xue tailored a strategic approach: 'Prioritize improving mature oocyte proportion using the PPOS (Progestin-Primed Ovarian Stimulation) protocol.'

Darnuo’s 'Oocyte Maturation Enhancement Strategy'—Three-Phase Breakdown

Pre-treatment Phase (pre-arrival in Thailand, ~Feb 16)

Based on comprehensive evaluation of her hormonal profile and ovarian response, no down-regulation or pre-treatment was required. Although AMH was low, her ovarian function had not progressed to absolute failure—making gentle, individualized stimulation appropriate.

Stimulation Phase (Feb 16–25)

Gradual dose escalation: Starting Gonal-F at 150 IU, with subsequent adjustments based on response

LH surge control: Oral dydrogesterone administered throughout to prevent premature ovulation

Mid-to-late phase addition of GnRH antagonist Cetrotide to optimize timing for oocyte retrieval

Highlights of remote management:

Home-based injections + daily WeChat feedback of monitoring results

Medical assistants precisely calculated trigger timing and proactively coordinated travel logistics for oocyte retrieval in Thailand

— Oocyte Retrieval & Laboratory Culture (Retrieval on Feb 25)

Mature oocyte rate surged from 0% to 80% (5 oocytes retrieved, 4 mature)

Blastocyst yield: 3 blastocysts—including one top-quality 4AA embryo

[图片:https://cdn.yun.sooce.cn/6/59417/png/17484170325624b5e575a57d0a5284a075370a3180043.png?version=1748417036][Photo: Darnuo lab’s blastocyst grading report showing 4AA embryo]

Expert Interpretation

Darnuo’s advanced laboratory technologies, dynamic cycle-by-cycle protocol adjustments, and seamless remote care coordination collectively and significantly enhance mature oocyte yield, embryo quality, and overall patient confidence.

Clinical Insight: Fertility preservation is a battle—and choosing the right platform is pivotal.

Even with low AMH and prior failed cycles, a professional clinical team, world-class laboratory expertise, and a compassionate, integrated service system can rewrite reproductive outcomes. Darnuo Reproductive Hospital in Thailand—using science as its pen and expertise as its ink—has authored a compelling success story for low-AMH patients, proving that every fertility dream holds the potential to bloom.

This article is a public-information summary published by WFA. It is intended for industry, media and the general public, and does not constitute medical or investment advice.