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Key Clinical Message  Few successful pregnancies after age 45 years with low ovarian reserve have been reported. We report a 46‐year‐old woman with basal  FSH  20.36  mIU / mL  and an antral follicle count of four obtained two embryos and delivered a healthy infant with  IVF  using a microdose Gn RH ‐a flare‐up protocol combined with Gn RH ‐ant.

Live birth in a 46‐year‐old woman using microdose Gn RH agonist flare‐up protocol combined with Gn RH antagonist: a case report