Rapid decline in ovarian reserve after repeated ART cycles in a 22-year-old IVF patient

Objective The objective was to discuss the rapid decline in ovarian reserve due to repeated assisted reproductive technologies (ART) in a 22-year-old patient.Methods This case report presents an infertile couple admitted to our IVF unit with the diagnosis of recurrent implantation failure and congenital uterine anomaly. Main outcome measures were the number of growing follicles and metaphase II oocytes retrieved.Results After recurrent implantation failure of three in vitro fertilization cycles, the couple underwent three consecutive intracytoplasmic sperm injection cycles in our center. With a high number of oocytes retrieved, first cycle resulted in implantation failure followed by an embryo transfer cancelled cycle. The third cycle was cancelled due to an unexpected poor response even with the highest gonadotrophin dose.Conclusion Rapid decrease in ovarian reserve should be considered when offering repeated ART cycles even if the woman is very young and has a good ovarian reserve.