Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase.
OBJECTIVE: To present a case of aberrant follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens, Greece. PATIENT(S): A 37-year-old white woman who was scheduled to undergo ovarian stimulation according to the long luteal phase protocol for IVF and ET because of male factor infertility. INTERVENTION(S): Twenty-first day serum P level was 5.9 ng/dL, and a daily dose of 0.1 mg leuprolide acetate was initiated. Fifteen days later the patient presented for evaluation because of absence of uterine bleeding. Sonographic evaluation revealed the presence of five large follicles. Serum E(2) and P levels at this time were 1,895.0 pg/mL and 0.2 ng/mL, respectively. The patient received recombinant hCG (250 mg), and 36 hours later she underwent oocyte retrieval. Three oocytes were retrieved and fertilized by intracytoplasmic sperm injection. After the transfer of two embryos a singleton pregnancy was achieved, leading to an uneventful delivery. MAIN OUTCOME MEASURE(S): Serum E(2) and P and ultrasound evaluation of ovaries. RESULT(S): She had a singleton pregnancy, and she delivered at 39 weeks of gestation. CONCLUSION(S): The presence of recruitable follicles during the luteal phase of the cycle that responded to endogenous gonadotropins during the flare response before pituitary suppression could be a logical explanation of this observation.
Vlahos, NF; Choussein, S; Economopoulos, KP
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