27/02/2026
Dr. Porrawan Tangtham (MD),Medical License : 36023 |“Patient Case Study: Overcoming Early Menopause to Welcome Twins”
By the time this patient reached me, she was already quite prepared. She had researched her symptoms extensively—not because she had gone through multiple failed ICSI cycles, but because her period had been missing for nearly a year. This led her to wonder, "Is something wrong with my body? Can I still have children?" 🥺😰
The Initial Diagnosis
The wife was 44 years old when we first met. As mentioned, she had classic symptoms; her periods had been absent for so long that she had already passed the hot flash stage. Suspecting she might be approaching menopause, we started with a physical exam and hormone testing.
• Ultrasound Results: The uterus was generally healthy but starting to shrink in size.
• The Critical Finding: The ovaries were no longer producing any eggs.
• Blood Work: Confirmed that the patient had indeed entered menopause.
A Light at the End of the Tunnel
When the results were presented, anxiety set in. However, since the patient had mentally prepared herself, she immediately asked: "Doctor, I want a baby so much. I regret coming to see you so late, but... in this case, can we use egg donation?" Hearing her open that door felt like seeing a light at the end of the tunnel. 🥹 When a patient with ovarian failure is open to using donor eggs, the path forward becomes much smoother.
The Treatment Journey
Once the couple fully understood the necessity of a donor, they moved quickly and found a donor in no time. Fortunately, the husband’s s***m quality was excellent. Here is the breakdown:
• Egg Retrieval: The donor yielded >30 eggs.
• Embryo Development: We successfully reached 10 high-quality embryos.
• Uterine Preparation: While waiting for the retrieval, I prescribed Hormone Replacement Therapy (HRT) for 2–3 months to "rehydrate" the uterus after a long period of hormone deficiency.
• The Lining: During the actual transfer cycle, the uterine lining reached a perfect, "fluffy" thickness of 9 mm.
The Transfers
1. First Transfer (D5 x 1, Grade AB): The hormone levels rose to 46 but then dropped. It was a bit discouraging, but I reassured them that the uterus was ready and capable of supporting a pregnancy. "Let's try one more time!" ✌🏻😄
2. Second Transfer: Worried about another failure, the patient requested to transfer two embryos. After discussing the risks of a twin pregnancy and receiving her consent, we transferred two D5 embryos.
The Result? A B-hcg level of 1,003! 🎉
Conclusion
It’s a "buy one, get one" success! They are having fraternal twins (boy and girl). 🧒🏼👧🏼 I am so incredibly happy for this couple. From the brink of losing hope and entering menopause to fighting through and successfully having twins! 🥹💚
