Eftekhar Maryam, Mohammadi Banafsheh, Tabibnejad Nasim, Razi Mohammad Hossein
Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Int J Reprod Biomed. 2021 Jul 27;19(6):569-574. doi: 10.18502/ijrm.v19i6.9378. eCollection 2021 Jun.
Some women represent the inability to respond to endogenous and exogenous gonadotropins during in vitro fertilization/intracytoplasmic sperm injection cycles leading to the follicular developmental arrest. The women with resistant ovaries could benefit from in vitro maturation.
This case-series presents pregnancies resulting from initially scheduled conventional in vitro fertilization which led to arrested cycles because of resistant ovary syndrome. The protocol was changed to early oocyte triggering for 15 women due to the small follicles 12 mm in diameter on day 15 after stimulation with high doses of exogenous gonadotrophins instead of cycle cancellation. Germinal vesicle and metaphase I oocytes that were retrieved from follicles were matured in vitro and inseminated by intracytoplasmic sperm injection. Twenty formed embryos were transferred on day 3 after oocyte retrieval. This resulted in a 30.76% chemical pregnancy out of which no abortion occurred. Therefore, we reported a 30.76% singleton ongoing pregnancy.
It seems that early oocyte triggering followed by in vitro maturation may be considered as a good modality in women experiencing follicular resistance to gonadotropins. These cycles can be rescued from cancellation with satisfactory clinical outcomes.
在体外受精/卵胞浆内单精子注射周期中，一些女性表现出对内源性和外源性促性腺激素无反应，导致卵泡发育停滞。卵巢抵抗的女性可能从体外成熟中获益。
本病例系列介绍了最初计划进行常规体外受精，但因卵巢抵抗综合征导致周期停滞的患者成功妊娠的情况。由于在高剂量外源性促性腺激素刺激后第15天卵泡直径小于12mm，15名患者的方案改为早期卵母细胞触发，而非取消周期。从卵泡中取出的生发泡期和中期I卵母细胞在体外成熟，并通过卵胞浆内单精子注射进行授精。在取卵后第3天移植了20个形成的胚胎。这导致了30.76%的生化妊娠，其中没有发生流产。因此，我们报告了30.76%的单胎持续妊娠。
对于对促性腺激素有卵泡抵抗的女性，早期卵母细胞触发后进行体外成熟似乎可被视为一种良好的方式。这些周期可以避免取消，获得满意的临床结果。
