Allergic reaction to a highly purified urinary follicle stimulating hormone preparation in controlled ovarian hyperstimulation for in vitro fertilization.
We report a case of general hypersensitivity-like allergic reactions to intramuscular injections of highly purified urinary follicle stimulating hormone (uFSH-HP) successfully managed by using intramuscular recombinant FSH (rFSH). The patient underwent a first cycle of in vitro fertilization (IVF) and controlled ovarian hyperstimulation (COH) was achieved with a combination of gonadotropin releasing hormone against (GnRH-a) and uFSH-HP. Because, after oocyte recovery, no fertilization occurred, the couple subsequently entered an intracytoplasmic sperm injection (ICSI) program. During the COH, the woman developed general hypersensitivity-like allergic reactions with itching, redness and swelling. Although there was regular follicular growth, the allergic symptoms worsened and, on day 8 of COH, the stimulation cycle was suspended. A few months later, the patient entered a new ICSI cycle. COH was achieved by using a combination of GnRH-a and rFSH. The cycle was completed and the patient did not report any allergic reaction. To avoid allergic reaction to the protein components of the urine-derived FSH preparations, the use of rFSH is suggested in those patients who present local and/or general hypersensitivity-like allergic reactions.
Department of Obstetrics and Gynecology, University of Modena, Italy.
C
C
Battaglia
M
M
Salvatori
G
G
Regnani
M R
MR
Primavera
A R
AR
Genazzani
P G
PG
Artini
A
A
Volpe
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004342:Drug Hypersensitivity; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D043373:Follicle Stimulating Hormone, Human; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007273:Injections, Intramuscular; D016729:Leuprolide / Q000008:administration & dosage; D008596:Menotropins / Q000008:administration & dosage / Q000276:immunology*; D010062:Ovulation Induction; D011994:Recombinant Proteins / Q000008:administration & dosage; D020554:Sperm Injections, Intracytoplasmic
D006063:Chorionic Gonadotropin; D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone; D016729:Leuprolide