Patient Undergoes Multiple Rounds of IVF Despite Non-Viable Eggs


This case involves a 35-year-old female and a 42-year-old male. The male patient previously underwent a vasectomy 6 years prior, but had it successfully reversed. After attempting to conceive for almost a year, they were referred to a fertility clinic. The couple was evaluated by the staff at the clinic, and after their fertility testing was completed, they were informed that there were no obvious issues and that they should have over 40 percent chance of conception. The female patient then underwent multiple unsuccessful cycles of IVF for over a year. At that point, the physician performed an Anti-Mullerian Hormone test. The results led to the physician’s assessment, in which the woman’s eggs were not viable, thus she had a 5% chance of conception.

Question(s) For Expert Witness

  • 1. What are the typical tests performed to assess a couples' fertility?
  • 2. When evaluating a woman's fertility, when do you perform an Anti-Mullerian Hormone Test?
  • 3. Are there any additional tests that you order after multiple rounds of unsuccessful IVF?

Expert Witness Response E-001024

When evaluating a couples’ fertility, typical tests include the assessment of ovarian reserve and ovulatory function, assessment of semen parameters, and assessment of tubal patency.

Expert Witness Response E-020708

For women over 35 or with otherwise unexplained infertility, some assessment of ovarian function should be performed. This could be Anti-Mullerian Hormone Test, follicle-stimulating hormone test or ultrasound follicle count. Semen analysis and hysterosalpingogram are also typically done. After multiple IVF failures, karyotype would help. Anti-Mullerian Hormone Test does not assess egg “viability”, only quantity.

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