TY - JOUR
T1 - Ovarian hyperresponse to luteal phase GnRH-agonist administration
AU - Depenbusch, Marion
AU - Diedrich, Klaus
AU - Griesinger, Georg
PY - 2010/6/1
Y1 - 2010/6/1
N2 - Introduction: Herein we report a case of ovarian hyperresponse after luteal phase GnRH-agonist administration in a woman planning to undergo ovarian stimulation for IVF in a long GnRH-agonist protocol. Materials and methods: A normogonadotropic 25-year-old woman undergoing ICSI treatment for male factor infertility underwent three cycles of controlled ovarian stimulation, two in a GnRH-antagonist protocol, one in a long luteal GnRH-agonist protocol. Results: In the first GnRH-antagonist cycle, ovarian stimulation was performed with 150 IE recombinant FSH and 22 oocytes were retrieved. In the second GnRH-antagonist cycle using the same protocol, six oocytes were retrieved. The estradiol levels on the day of hCG administration were 3,692 and 3,209 pg/ml, respectively. In a third cycle, 3.75 mg triptorelin was administered in the luteal phase and the patient showed ovarian hyperresponse to the endogenous gonadotropin flare with estradiol levels of 19,102 pg/ml, abdominal distension and discomfort, and massive bilateral ovarian enlargement (total ovarian volume 268 cm3). Ovarian cysts persisted for 4 weeks and necessitated cyst aspiration before further treatment. Conclusion: The flare-up effect of GnRH-agonist administration can, in rare cases, cause massive ovarian hyperresponse with associated health risks and significant postponement of treatment.
AB - Introduction: Herein we report a case of ovarian hyperresponse after luteal phase GnRH-agonist administration in a woman planning to undergo ovarian stimulation for IVF in a long GnRH-agonist protocol. Materials and methods: A normogonadotropic 25-year-old woman undergoing ICSI treatment for male factor infertility underwent three cycles of controlled ovarian stimulation, two in a GnRH-antagonist protocol, one in a long luteal GnRH-agonist protocol. Results: In the first GnRH-antagonist cycle, ovarian stimulation was performed with 150 IE recombinant FSH and 22 oocytes were retrieved. In the second GnRH-antagonist cycle using the same protocol, six oocytes were retrieved. The estradiol levels on the day of hCG administration were 3,692 and 3,209 pg/ml, respectively. In a third cycle, 3.75 mg triptorelin was administered in the luteal phase and the patient showed ovarian hyperresponse to the endogenous gonadotropin flare with estradiol levels of 19,102 pg/ml, abdominal distension and discomfort, and massive bilateral ovarian enlargement (total ovarian volume 268 cm3). Ovarian cysts persisted for 4 weeks and necessitated cyst aspiration before further treatment. Conclusion: The flare-up effect of GnRH-agonist administration can, in rare cases, cause massive ovarian hyperresponse with associated health risks and significant postponement of treatment.
UR - http://www.scopus.com/inward/record.url?scp=77953652077&partnerID=8YFLogxK
U2 - 10.1007/s00404-009-1309-4
DO - 10.1007/s00404-009-1309-4
M3 - Journal articles
C2 - 19960348
AN - SCOPUS:77953652077
SN - 0932-0067
VL - 281
SP - 1071
EP - 1072
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 6
ER -