{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:02:29Z","timestamp":1753891349594,"version":"3.41.2"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Advanced maternal age and diminished ovarian reserve (DOR) are challenges in infertile patients for <jats:italic>in vitro<\/jats:italic> fertilization-embryo transfer (IVF-ET). This study aimed to investigate the pregnancy outcomes of women with advanced age and DOR undergoing low-quality embryo transfers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>We report a rare case of successful pregnancy resulting from a zero pronuclei (0PN)-derived four-cell embryo transfer on day 4 (D4). An advanced age patient with DOR underwent five unsuccessful embryo transfers. A successful outcome was achieved when the patient underwent a hormone replacement FET cycle and received 0PN-derived four-cell frozen-thawed cleavage embryo transfer on D4. Fourteen days after the transfer, her serum \u03b2-human chorionic gonadotropin level was 575.3 mIU\/mL. Subsequent prenatal examinations were normal, and the patient delivered a full-term healthy baby girl by caesarean section. Achieving a successful pregnancy after 0PN-derived four-cell frozen-thawed embryo transfer on D4 is rare. This increasingly exhibits significance for advanced age patients with DOR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Selectively transferring embryos with slow growth but low fragments and no evident damage is beneficial for advanced age patients with DOR. For these individuals, obtaining embryos is challenging. Therefore, a personalized embryo transfer strategy should be considered to increase the possibility of pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1462425","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T04:38:13Z","timestamp":1727152693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced age woman with diminished ovarian reserve obtained live birth following a zero pronuclei-derived four-cell frozen-thawed embryo transfer on day 4: a case report"],"prefix":"10.3389","volume":"11","author":[{"given":"Xiao-lei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-qian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-juan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/s0015-0282(01)02017-9","article-title":"Reproductive outcome in patients with diminished ovarian reserve","volume":"76","author":"Levi","year":"2001","journal-title":"Fertil Steril"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s10815-020-01708-7","article-title":"Morula transfer achieves better clinical outcomes than post-thawed cleavage embryos after overnight culture 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