Mahajan Sanket, More Akash, Dutta Shilpa, Shrivastava Jarul, Nawale Neha, Choudhary Namrata
Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Clinical embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Feb 23;16(2):e54743. doi: 10.7759/cureus.54743. eCollection 2024 Feb.
In this case study, a 39-year-old woman pursuing treatment for secondary infertility at our infertility clinic was visited by her 42-year-old husband. The couple had a history of failed attempts, including two intrauterine insemination (IUI), two intracytoplasmic sperm injection (ICSI) cycles, and two miscarriages. Diminished ovarian reserve (DOR) was noted in the patient's medical profile. A gonadotropin-releasing hormone (GnRH) antagonist, cetrorelix acetate, was given to the patient at a daily dosage of 0.25 mg to treat their condition once the maturing follicle had grown to a diameter of 10 mm. Following the administration of the GnRH antagonist, the first oocyte pick-up (OPU) procedure was conducted. During this process, two oocytes were successfully retrieved. Subsequently, ICSI was performed to facilitate fertilization. However, during the fertilization check, it was observed that no pronuclear fertilization (PN) formations occurred, leading to a cessation of development. Following the initial failure, an ovarian stimulation strategy based on progestin priming was implemented. Progestin is administered using this technique to ready the endometrium for the implantation of the embryo. After the modified ovarian stimulation protocol, an additional beta-human chorionic gonadotropin (β-hCG) test was verified as a successful clinical pregnancy outcome.
在本病例研究中，一名39岁的女性在我们的不孕不育诊所寻求继发性不孕治疗，她42岁的丈夫前来陪同。这对夫妇有多次治疗失败的病史，包括两次宫腔内人工授精（IUI）、两次卵胞浆内单精子注射（ICSI）周期以及两次流产。患者的病历显示卵巢储备功能下降（DOR）。当成熟卵泡直径长到10毫米时，给患者使用促性腺激素释放激素（GnRH）拮抗剂醋酸西曲瑞克，每日剂量为0.25毫克来治疗其病情。在给予GnRH拮抗剂后，进行了首次卵母细胞采集（OPU）程序。在此过程中，成功采集到两个卵母细胞。随后，进行了ICSI以促进受精。然而，在受精检查时，发现没有原核受精（PN）形成，导致发育停止。在初次失败后，实施了基于孕激素预处理的卵巢刺激策略。使用该技术给予孕激素以使子宫内膜为胚胎着床做好准备。经过改良的卵巢刺激方案后，额外的β-人绒毛膜促性腺激素（β-hCG）检测被确认为成功的临床妊娠结局。
