A 38-year-old patient with diminished ovarian reserve and an AMH of 0.9 ng/mL asked me, "Doctor, is the success rate at the First Affiliated Hospital of Zhengzhou University really high? Can I succeed with IVF given my condition?" — There is no simple yes or no answer to this question, but it can be broken down from three levels: the overall level of the center, the patient's individual conditions, and the key steps in the treatment process.
The True Level of IVF Success Rates at the First Affiliated Hospital of Zhengzhou University
According to academic data publicly released by the center and information exchanged within the industry (statistical measure: clinical pregnancy rate after fresh embryo transfer, i.e., gestational sac visible on ultrasound):
- Under 35 years old: Clinical pregnancy rate approximately 55%～65%, live birth rate approximately 45%～55%.
- 35～39 years old: Clinical pregnancy rate approximately 40%～50%, live birth rate approximately 30%～40%.
- 40～42 years old: Clinical pregnancy rate approximately 20%～30%, live birth rate approximately 15%～20%.
- Over 43 years old: Clinical pregnancy rate below 10%, often recommended to consider egg donation or adoption.
These figures place it in the same tier as top domestic reproductive centers (such as Peking University Third Hospital and Shanghai Ninth People's Hospital). However, the success rate is not a fixed number and is greatly influenced by the composition of the patient population — if this center treats a large number of older patients or those with poor ovarian function, the overall data will be "pulled down"; conversely, if there are more young patients with simple tubal factors, the data will be higher.
Age is the Primary Variable for Success Rate
When evaluating, reproductive doctors place the most emphasis on female age, as it directly determines the rate of chromosomal aneuploidy in eggs. Below are typical scenarios for different age groups:
| Age Group | Egg Normal Rate (Aneuploidy Rate) | Recommended Strategy |
|---|---|---|
| ≤35 years | Approximately 50%～60% normal | Conventional IVF/ICSI, fresh embryo transfer preferred |
| 36～40 years | Approximately 30%～40% normal | PGT-A screening recommended, elective transfer after blastocyst culture |
| 41～45 years | Approximately 10%～20% normal | Strongly recommend PGT-A, consider egg donation |
The Reproductive Center of the First Affiliated Hospital of Zhengzhou University has a standardized protocol for older patients: for those over 40, PGT-A is actively recommended, and endometrial receptivity testing (ERA) is performed before transfer. This is key to improving the cumulative live birth rate.
The Most Easily Overlooked Detail: Matching Endometrial Receptivity and Embryo Quality
Many patients focus all their attention on "how many eggs were retrieved" but overlook three details:
- Endometrial Receptivity: Even with a high-quality blastocyst, an endometrium < 7mm, chronic endometritis, or a displaced implantation window can lead to implantation failure. The First Affiliated Hospital of Zhengzhou University routinely performs hysteroscopy and endometrial microbiome testing.
- Embryo Chromosomal Euploidy: Morphologically high-scoring embryos still have a 30%～40% chance of being aneuploid. PGT-A can reduce the miscarriage rate but does not increase the success rate per single transfer (because abnormal embryos are excluded).
- Male Factors: Severe sperm DNA fragmentation (DFI > 30%) can lead to embryo developmental arrest or recurrent miscarriage, yet many patients only undergo routine semen analysis.
A 40-year-old patient with AMH 1.2 ng/mL had 8 eggs retrieved, forming 4 blastocysts. After PGT-A, only 1 embryo was normal, and transfer resulted in a successful pregnancy. If she had not undergone PGT and directly transferred an aneuploid embryo, the outcome would likely have been failure. This detail determines success or failure.
Three Common Pitfalls to Avoid
- Blindly pursuing centers with "high success rates": Each center uses different statistical measures (clinical pregnancy rate, live birth rate, cumulative live birth rate per oocyte retrieval cycle), and patient baselines differ. The First Affiliated Hospital of Zhengzhou University treats a high proportion of high-risk pregnancies; its absolute figures may not "look better" than some private centers, but its comprehensive capabilities are stronger.
- Ignoring individualized ovarian stimulation protocols: The same protocol can have vastly different effects on different individuals. Doctors at the First Affiliated Hospital of Zhengzhou University choose antagonist protocols, PPOS protocols, or mild stimulation protocols based on AMH, FSH, LH, and antral follicle count. Patients should not demand a "one-size-fits-all" protocol.
- Excessive anxiety after transfer affecting endocrine function: Frequent pregnancy testing and stress can cause uterine contractions. It is recommended to follow the doctor's advice on luteal phase support and have a blood test for HCG on days 12-14.
The Actual Process of IVF at the First Affiliated Hospital of Zhengzhou University
From the initial outpatient visit to confirming pregnancy typically takes 2 to 4 months (depending on the stimulation protocol and embryo culture strategy).
Step 1: Comprehensive Examination for Both Partners
Timing: For the woman, days 2-4 of menstruation (sex hormones + vaginal ultrasound + AMH). For the man, semen analysis after 2-7 days of abstinence. Other tests (chromosomes, infectious diseases, thyroid function) are not time-sensitive.
Step 2: Developing an Individualized Protocol
Choose an ovarian stimulation protocol based on test results. Common protocols and their suitable populations:
| Protocol | Suitable Population | Stimulation Duration |
|---|---|---|
| Antagonist Protocol | Normal or high AMH, PCOS | Approximately 10-12 days |
| PPOS Protocol | Diminished Ovarian Reserve (DOR) | Approximately 10-14 days |
| Mild Stimulation Protocol | Advanced age, AMH < 1.0 ng/mL | Approximately 8-10 days |
Step 3: Egg Retrieval and In Vitro Culture
The egg retrieval procedure takes about 15-20 minutes under intravenous anesthesia. Embryos are observed on day 3 post-retrieval, and blastocysts form on days 5-6. The decision to perform PGT-A must be made in advance.
Step 4: Transfer and Luteal Phase Support
A frozen embryo cycle requires preparing the endometrium first (about 10-14 days). Progesterone or dydrogesterone is used after transfer. Blood HCG is checked 12-14 days after transfer.
Interpretation of Key Examination Indicators
- AMH: Reflects ovarian reserve. AMH < 1.0 ng/mL indicates diminished reserve, requiring individualized stimulation or consideration of egg donation.
- FSH: Basal FSH > 10 IU/L suggests decreased ovarian response.
- Antral Follicle Count (AFC): Total AFC < 5 across both ovaries indicates a high cycle cancellation rate.
- Sperm DNA Fragmentation Index (DFI): DFI > 30% suggests antioxidant therapy or testicular sperm extraction.
- Chromosome Karyotype: Conditions like balanced translocation or Robertsonian translocation require PGT-SR.
Frequently Asked Questions
Q: Can I still do IVF if my AMH is low?
A: Yes, but the number of eggs retrieved may be low. The First Affiliated Hospital of Zhengzhou University commonly uses the PPOS protocol or mild stimulation for patients with AMH < 1.0, accumulating embryos for frozen embryo transfer. The success rate per cycle is lower than for those with normal reserve, but the cumulative live birth rate is still 20%～30%.
Q: How long does it take to prepare?
A: From initial examination to transfer takes about 2-4 months. If PGT is needed, the frozen cycle requires 1-2 months to wait for results.
Q: What are the risks?
A: The incidence of OHSS (Ovarian Hyperstimulation Syndrome) is about 1%～3%, along with risks of multiple pregnancy, miscarriage, and ectopic pregnancy. The First Affiliated Hospital of Zhengzhou University has a comprehensive OHSS prevention and management protocol.
Doctor's Advice
If you are under 38 years old, have an AMH > 1.5 ng/mL, and no severe uterine abnormalities, the success rate at the First Affiliated Hospital of Zhengzhou University is trustworthy. However, if you are of advanced age, have poor ovarian reserve, or a history of recurrent implantation failure, don't just focus on the word "success rate." Instead, pay attention to:
- Whether the doctor has designed an individualized plan for you, including endometrial preparation and embryo screening.
- Whether necessary etiological investigations (immunology, coagulation, chronic endometritis) have been performed.
- Whether there is a clear cumulative cycle plan (e.g., accumulating embryos first, then performing hysteroscopy, and finally transferring).
The success rate is a statistic, but your treatment is a series of decisions. It is more meaningful to shift the question from "Is this hospital's success rate high?" to "What tests should I do, which protocol should I choose, and what details should I pay attention to?"
⚠️ Risk Reminder
No IVF treatment can guarantee 100% success. This data is based on recent academic reports and peer reviews from the First Affiliated Hospital of Zhengzhou University, and individual differences are significant. Please rely on the in-person evaluation of your attending physician. If you have a history of miscarriage, chronic disease, or family genetic history, be sure to complete genetic counseling before starting the cycle.
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