Trigger Time in Advanced Maternal Age Patients With Low AMH

Inclusion Criteria: * • POR defined according to the Bologna criteria: * AMA: ≥40 years and AMH \<1.1 ng/ml * Previous poor ovarian response with maximum 3 cumulus oocyte complexes retrieved after conventional stimulation * Antral follicle count \< 5-7 * Cycling patients * Fresh ejaculates * ICSI * BMI 19-32 kg/m2 * Ovarian stimulation protocol: Antagonist HMG 450 IU to ensure all receptors are covered and to ensure maximum recruitment. Dose adjustments can be made after 5 days of stimulation * Type of trigger for final oocyte maturation: dual trigger: 10.000 IU hCG i.m. and 0.3 mg Deca * Couples requesting preimplantation genetic testing (for aneuploidies) of their embryos * Follicular measurements should be performed at IVI RMA Fertility, Abu Dhabi, UAE: a single operator will perform the ultrasound for the final measurement before trigger. Recruitment can be done by all physicians * Only patients with an oral contraceptive pill (OCP) pretreatment to synchronize follicular development: * 2 weeks OCP followed by * a wash out of 5 days (without OCP) followed by * o start stimulation * Basal hormone profile (FSH, LH, E2, P4) measured between day 1-3 at IVIRMA Fertility, Abu Dhabi, UAE * FSH \<15 IU * E2 \<50 pg/ml * P \<1ng/ml * Only the Arab population * Oocyte retrieval: 36 hours after trigger * PGT-A Exclusion Criteria: * If follicular measurement before randomization shows a leading follicle ≥ 1…