A Case of Successful Delivery in An Infertile Patient with Ovarian Resistance Syndrome: Treated with Antagonist Protocol and Fresh-Embryo Transfer

doi:10.12280/gjszjk.20210634

Abstract

Abstract:

Resistant ovarian syndrome (ROS) is a reproductive endocrine disorder of unknown etiology, with a low incidence and mainly leading to infertility. The complicated treatment and long procedure cause the anxiety of ROS patients. In this paper, we report a case of an infertile patient with ROS, who underwent in vitro fertilization and embryo transfer (IVF-ET) for successful pregnancy. The patient had failed to conceive after several in vitro fertilization treatments at an outside hospital because of her primary infertility, ineffective ovulation treatment, and low response to exogenous gonadotropin (Gn). In the following treatment in our hospital, we adjusted her Gn level and finally obtained a live birth after fresh embryo transfer with an antagonist regimen. Through a retrospective analysis of the relevant literatures, we hope to explore the possible reasons for the successful treatment of this ROS case, and to provide new ideas for the clinical management of ROS patients, so that we can achieve a more satisfactory pregnancy outcome while reducing the cost of treatment.

Key words: Ovary, Syndrome, Infertility, female, Gonadotropins, Fertilization in vitro, Embryo transfer

CHEN Ya-nan, GUO Jia-li, LI Ze-wu, YANG Ai-jun. A Case of Successful Delivery in An Infertile Patient with Ovarian Resistance Syndrome: Treated with Antagonist Protocol and Fresh-Embryo Transfer[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(4): 294-297.

References 16

[1]	de Moraes-Ruehsen M, Jones GS. Premature ovarian failure[J]. Fertil Steril, 1967, 18(4):440-461. doi: 10.1016/s0015-0282(16)36362-2. doi: 10.1016/s0015-0282(16)36362-2 pmid: 6028784
[2]	马良坤, 林守清. 卵巢早衰与卵巢不敏感综合征[J]. 实用妇产科杂志, 2003, 19(4):198-200. doi: 10.3969/j.issn.1003-6946.2003.04.004. doi: 10.3969/j.issn.1003-6946.2003.04.004
[3]	黄宝怡, 许培, 刘曼婷, 等. 卵巢抵抗综合征分级及病因研究[J]. 中国实用妇科与产科杂志, 2017, 33(9):963-966. doi: 10.19538/j.fk2017090120. doi: 10.19538/j.fk2017090120
[4]	李汶, 何文斌, 周立花, 等. 两个FSHR基因新突变导致的卵巢抵抗综合征研究[J]. 中华医学遗传学杂志, 2017, 34(2):196-199. doi: 10.3760/cma.j.issn.1003-9406.2017.02.009. doi: 10.3760/cma.j.issn.1003-9406.2017.02.009
[5]	Flageole C, Toufaily C, Bernard DJ, et al. Successful in vitro maturation of oocytes in a woman with gonadotropin-resistant ovary syndrome associated with a novel combination of FSH receptor gene variants: a case report[J]. J Assist Reprod Genet, 2019, 36(3):425-432. doi: 10.1007/s10815-018-1394-z. doi: 10.1007/s10815-018-1394-z URL
[6]	He WB, Du J, Yang XW, et al. Novel inactivating mutations in the FSH receptor cause premature ovarian insufficiency with resistant ovary syndrome[J]. Reprod Biomed Online, 2019, 38(3):397-406. doi: 10.1016/j.rbmo.2018.11.011. doi: 10.1016/j.rbmo.2018.11.011 URL
[7]	牟珍妮, 孙振高, 宋景艳, 等. 卵巢不敏感综合征发病机制及管理策略的研究进展[J]. 现代妇产科进展, 2018, 27(3):232-234. doi: 10.13283/j.cnki.xdfckjz.2018.03.018. doi: 10.13283/j.cnki.xdfckjz.2018.03.018
[8]	Aslam MF, Gilmour K, McCune GS. Spontaneous pregnancies in patients with resistant ovary syndrome while on HRT[J]. J Obstet Gynaecol, 2004, 24(5):573-574. doi: 10.1080/01443610410001722707. doi: 10.1080/01443610410001722707 pmid: 15369944
[9]	Mu Z, Song J, Yu Y, et al. Successful live birth in a woman with resistant ovary syndrome treated with letrozole and HMG: A case report[J]. Medicine(Baltimore), 2020, 99(20):e20199. doi: 10.1097/MD.0000000000020199. doi: 10.1097/MD.0000000000020199
[10]	Grynberg M, Peltoketo H, Christin-Maître S, et al. First birth achieved after in vitro maturation of oocytes from a woman endowed with multiple antral follicles unresponsive to follicle-stimulating hormone[J]. J Clin Endocrinol Metab, 2013, 98(11):4493-4498. doi: 10.1210/jc.2013-1967. doi: 10.1210/jc.2013-1967 pmid: 23956344
[11]	Li Y, Pan P, Yuan P, et al. Successful live birth in a woman with resistant ovary syndrome following in vitro maturation of oocytes[J]. J Ovarian Res, 2016, 9(1):54. doi: 10.1186/s13048-016-0263-6. doi: 10.1186/s13048-016-0263-6 pmid: 27599836
[12]	Galvão A, Segers I, Smitz J, et al. In vitro maturation (IVM) of oocytes in patients with resistant ovary syndrome and in patients with repeated deficient oocyte maturation[J]. J Assist Reprod Genet, 2018, 35(12):2161-2171. doi: 10.1007/s10815-018-1317-z. doi: 10.1007/s10815-018-1317-z URL
[13]	张真真, 韩婷, 李敬, 等. 卵巢抵抗综合征不孕患者行卵子体外成熟培养后冻胚移植足月分娩1例[J]. 山东大学学报(医学版), 2019, 57(2):117-119. doi: 10.6040/j.issn.1671-7554.0.2018.824. doi: 10.6040/j.issn.1671-7554.0.2018.824
[14]	许定飞, 伍琼芳. 持续性异常高FSH患者应用超长方案行IVF-ET治疗获临床妊娠1例报道[J]. 江西医药, 2014, 49(12):1489-1491. doi: 10.3969/j.issn.1006-2238.2014.12.065. doi: 10.3969/j.issn.1006-2238.2014.12.065
[15]	Rogenhofer N, Pavlik R, Jeschke U, et al. Effective ovarian stimulation in a patient with resistant ovary syndrome and antigonadotrophin antibodies[J]. Am J Reprod Immunol, 2015, 73(2):185-191. doi: 10.1111/aji.12306. doi: 10.1111/aji.12306 URL
[16]	杨蕊, 王颖, 张春梅, 等. 卵巢不敏感综合征不孕患者助孕病例分析及文献回顾[J]. 中华生殖与避孕杂志, 2020, 40(1):45-49. doi: 10.3760/cma.j.issn.2096-2916.2020.0003. doi: 10.3760/cma.j.issn.2096-2916.2020.0003