Recurrent implantation failure (RIF) and diminished ovarian reserve pose significant challenges in assisted reproductive technology (ART). While standard IVF protocols succeed in many cases, complex infertility requires precision-driven interventions customised to individual reproductive profiles. A recent case at Oasis Fertility, Vijayawada, illustrates how a data-driven, multidisciplinary approach enabled pregnancy after nine failed treatment cycles. A 30-year-old female patient with five years of primary infertility had previously undergone four unsuccessful intrauterine insemination (IUI) cycles and four failed in-vitro fertilization (IVF) cycles each characterized by implantation failure, embryo arrest, or genetic abnormalities. Comprehensive diagnostics at Oasis Fertility revealed Stage 2 endometriosis, a uterine septum, chronic endometrial inflammation (BCL6 positivity), low ovarian reserve, and hypothyroidism. The male partner exhibited normozoospermia with a DNA Fragmentation Index (DFI) of 8%, suggesting minimal male-factor impact. To improve ovarian response, a customized stimulation protocol was implemented, integrating platelet-rich plasma (PRP) therapy for ovarian rejuvenation, growth hormone and Testogel pre-treatment, and an ultra-flare IVF protocol with pergoveris and GH. The double stimulation (DuoStim) cycle with ICSI and frozen microfluidics optimized egg retrieval, yielding seven oocytes, of which three were confirmed euploid via Preimplantation Genetic Testing for Aneuploidy (PGT-A).
However, endometrial factors posed additional barriers. The first frozen embryo transfer (FET) cycle was cancelled due to insufficient endometrial thickness (<7mm). An Endometrial Receptivity Analysis (ERA) was conducted, identifying the optimal implantation window at 120 ± 3 hours. The second FET cycle in during the summers of 2024, i.e. in March 2024 incorporated a PRP flush to enhance endometrial receptivity and a Recurrent Implantation Failure (RIF) protocol, including low-dose aspirin and LMWH to improve implantation success. Dr Sujata Vellanki's meticulous planning at Oasis Fertility, Vijayawada yielded a positive pregnancy report with a beta hCG level of 838.35. The patient is now 35 weeks pregnant, demonstrating the efficacy of advanced ovarian stimulation, embryo selection, and precision-timed implantation in overcoming RIF.
