Ansari Al Hera, More Akash, Dutta Shilpa, Choudhary Namrata, Shrivastava Jarul, Shaikh Rokaiya
Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Feb 11;16(2):e54023. doi: 10.7759/cureus.54023. eCollection 2024 Feb.
The case study examined a 32-year-old female and her 35-year-old partner who had experienced infertility attributed to the wife's irregular ovulation. Despite the male partner demonstrating normal reproductive parameters, he had a medical history involving hypertension. The woman also had a history of hypertension and chikungunya, which was accompanied by fever and joint pain in 2019. Due to the woman's allergic reaction to traditional ovulation stimulatory medications, the approach to assisted reproductive technologies (ART) had shifted towards employing the short agonist stop (SAS) regimen. Controlled ovarian stimulation had been achieved by administering recombinant follicular hormone, gonadotropin-releasing hormone (GnRH), and estrogen. The SAS protocol had been introduced to counter premature ovulation and synchronize follicular development. Following two successful ovum pickup procedures resulting in the retrieval of six embryos, the initial frozen embryo transfer took place in April 2022. Daily progesterone supplementation had been administered to sustain the patient's luteal phase. A subsequent human chorionic gonadotropin (β-hCG) test performed on the 14 day post-embryo transfer confirmed a positive pregnancy diagnosis, with a measured outcome of 2026 mIU/mL. This case highlighted the potential impact of medication allergies on fertility outcomes and underscored the unique approach of the SAS protocol in managing allergic responses during in vitro fertilization (IVF) procedures. Despite the patient's history of allergic reactions to conventional ovulation stimulatory medications, the study concluded that the implementation of the brief agonist stop strategy had resulted in a successful clinical pregnancy.
该案例研究考察了一名32岁女性及其35岁伴侣，该女性因排卵不规律而不孕。尽管男性伴侣的生殖参数正常，但他有高血压病史。该女性也有高血压和基孔肯雅热病史，2019年伴有发热和关节疼痛。由于该女性对传统排卵刺激药物过敏，辅助生殖技术（ART）的方法已转向采用短效激动剂停药（SAS）方案。通过注射重组卵泡激素、促性腺激素释放激素（GnRH）和雌激素实现了控制性卵巢刺激。引入SAS方案是为了对抗过早排卵并同步卵泡发育。在两次成功的取卵程序获得6个胚胎后，首次冻融胚胎移植于2022年4月进行。每天补充孕酮以维持患者的黄体期。在胚胎移植后第14天进行的后续人绒毛膜促性腺激素（β-hCG）检测证实妊娠诊断呈阳性，检测结果为2026 mIU/mL。该案例突出了药物过敏对生育结果的潜在影响，并强调了SAS方案在体外受精（IVF）程序中管理过敏反应的独特方法。尽管患者对传统排卵刺激药物有过敏史，但研究得出结论，实施短效激动剂停药策略已导致临床妊娠成功。
