30 year old wife with AMH of 8 ng/mL undergoing ICSI for Male Factor consumed recFSH 2600 IU in the 10 day stimulation protocol and landed up with severe hyperstimulation. 42 oocytes with 15 MII recovered. Five embryos ( 1A + 4C) were vitrified on day 3. 4 months later an FET with 3 Embryos was negative. After this she had 4 more cycles of IVF Lite and 6 Grade A embryos were vitrified. She conceived in the second rFET cycle after 4 months with 2 Grade A embryos transferred and delivered healthy twins in December 2015.
38 year old with history of two previous IVF conceptions with preterm labor at 6 months and no living children. Underwent a conventional IVF stem with recFSH of 3000 IU in the cycle. 20 oocytes, 19 MII, 16 fertilized and 6 Blastocysts Vitrified. 2 Blasts Grade AA were transferred into a Surrogate. Surrogate conceived and a mild form of Lobar Holoprosencephaly was diagnosed in the Anomaly scan – Quadruple marker test and Karyotyping was suggested. Amniocentesis and Foetal Blood Sampling was done.FBS revealed low grade and tissue specific Mosaicism. MTP was done. Six months later, a second transfer of Day 5 2 AA Blasts was done leading to a missed abortion at 9 weeks. POCs sent for Karyotyping which was normal and microarray showed Deletion on X Chromosome with Mosaic loss on entire X chromosome. Karyotyping of the couple revealed male partner having normal analysis and wife was diagnosed with pericentric inversion of Chromosome 9 at p11q13 region and large satellite on chromosome 15. In May 2016 PGS by NGS was done on the Day 5 cryopreserved embryos which revealed out of 4 sent only 1 was Normal.
In July 2016 she underwent IVF Lite, 3 Oocytes, 3 MII, 3(2PN) Fertilized, 2 Blastocysts formed( 4AA,2BB). Simultaneously in July 2016: Surrogate Transfer with 1 Blastocyst (after PGS) was done – Positive Pregnancy test (Beta-HCG -487.21 ) now with single live intrauterine pregnancy.