Cao Xian-Ling, Sun Zhen-Gao
College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China.
Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China.
World J Clin Cases. 2020 Feb 26;8(4):825-830. doi: 10.12998/wjcc.v8.i4.825.
Borderline form of empty follicle syndrome is a condition in which only a few mature or immature oocytes are recovered after meticulous follicular aspiration, despite adequate ovarian response to stimulation. It is a rare phenomenon with an unclear cause. Currently, the condition still lacks effective treatment.
A patient with secondary infertility who had undergone three cycles of assisted reproductive technique (ART) is described. With regard to good follicular response, two oocytes were obtained in the first two ART cycles, but no embryo was formed. In the third ART cycle, which is the subject of this study, ovulation was induced by dual trigger of a supernormal dose of human chorionic gonadotropin (HCG) combined with a delayed oocyte retrieval approach. The method involved administration of gonadotropin-releasing hormone agonist, recombinant HCG, and urinary HCG 39 h before ovum pick-up. Ten oocytes were recovered, two out of three mature eggs were fertilized after intracytoplasmic sperm injection, resulting in two embryos that were subsequently cryopreserved. The case report guidelines have been used herein to present the first case of this novel dual trigger method.
This approach provides a new treatment option for patients with a similar condition in the future. This study can also inspire further investigation on the effects of various β-HCG serum levels 36 h after intramuscular HCG administration.
临界型空卵泡综合征是一种尽管卵巢对刺激有充分反应,但在细致的卵泡抽吸后仅回收少数成熟或未成熟卵母细胞的病症。它是一种原因不明的罕见现象。目前,该病症仍缺乏有效治疗方法。
本文描述了一位经历过三个周期辅助生殖技术(ART)的继发性不孕患者。鉴于卵泡反应良好,在前两个ART周期中获得了两个卵母细胞,但未形成胚胎。在本研究的第三个ART周期中,采用超正常剂量人绒毛膜促性腺激素(HCG)联合延迟取卵方法的双重触发来诱导排卵。该方法包括在取卵前39小时给予促性腺激素释放激素激动剂、重组HCG和尿HCG。回收了10个卵母细胞,三个成熟卵子中的两个在卵胞浆内单精子注射后受精,产生了两个胚胎,随后进行了冷冻保存。本文使用病例报告指南介绍了这种新型双重触发方法的首例病例。
这种方法为未来患有类似病症的患者提供了一种新的治疗选择。本研究还可激发对肌肉注射HCG后36小时各种β-HCG血清水平影响的进一步研究。