Title:Ovarian Hyperresponse Following the Sole Administration of GnRH
Agonist
Volume: 25
Issue: 6
Author(s): Cheng Chen, Lan Geng, Zhenhui Hou, Dan Liu, Fanhua Meng, Wenmin Ma*Xi Xia*
Affiliation:
- Reproductive Center, Foshan Maternal and Child Health Care Hospital, Foshan, China
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, China
Keywords:
GnRH agonist, ovarian hyperstimulation, assisted reproductive technology, polycystic ovary syndrome, gonadotropins, GnRHa.
Abstract:
Background: The gonadotrophin-releasing hormone agonist (GnRHa) has gained
widespread popularity in achieving pituitary suppression before ovarian stimulation with
exogenous gonadotropins in assisted reproductive technology protocols. However, a very small
part of patients may develop ovarian hyper response after the sole administration of GnRHa
without gonadotropins.
Case Report: A 32-year-old female diagnosed with polycystic ovary syndrome presented for her
second IVF cycle in our reproductive center. Twenty-eight days after 3.75mg triptorelin was
administrated on day 2 of her menstrual cycle, bilateral ovaries were significantly enlarged and
presented multiple cystic masses. The hormone profile was as follows: E24870pg/ml, P
13.19ng/ml, FSH 14IU/L, and LH 10.77IU/L. The patient felt symptoms of mild ovarian
hyperstimulation syndrome. In the subsequent IVF treatment cycle, antagonist protocol was
performed. It showed that follicles developed slowly and exogenous gonadotropins were used for
13 days. Finally, seven oocytes were obtained, and only one blastocyst graded 4BC formed.
Conclusion: Ovarian hyperstimulation following the sole administration of GnRHa can occur, but
the mechanism is still not yet clear. Antagonist protocol may be an alternative fertility strategy, but
the risk of poor embryo quality and low pregnancy rate of transplantation should be warned.
