Intracytoplasmic sperm injection pregnancy after low-dose human chorionic gonadotropin alone to support ovarian folliculogenesis.
OBJECTIVE
To prove that several days of low-dose hCG alone can be used to stimulate folliculogenesis, complete FSH-initiated follicle/oocyte maturation, and achieve pregnancy in assisted reproduction technology.


METHODS
Case report.


METHODS
Reproductive endocrinology center at an academic institution.


METHODS
A 35-year-old female patient and her partner with male-related infertility.


METHODS
After an 8-day priming with hMG (225 IU/d), we administered low-dose hCG (200 IU/d) alone for 5 days in one GnRH-agonist suppressed patient until proper follicle development was obtained and intracytoplasmic sperm injection was performed.


METHODS
Daily serum levels of LH, FSH, hCG, E(2), P, and T; measurements of follicle number and size; oocytes retrieved and fertilized; pregnancy.


RESULTS
Although FSH levels rapidly declined after hMG discontinuation, E(2) and large follicles increased during hCG-only administration. Several good quality oocytes were retrieved and fertilized by intracytoplasmic sperm injection; three embryos were transferred and a twin pregnancy ensued.


CONCLUSIONS
Replacement of FSH with low-dose hCG for several days in the late ovulation induction stages of assisted reproduction technology resulted in: [1] continued growth of large ovarian follicles and E(2); [2] an optimal preovulatory follicle pattern consisting of many large and few medium and small follicles; and [3] reproductively competent oocytes and pregnancy.
Filicori
Marco
M
Reproductive Endocrinology Center, Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy. fillicori@med.unibo.it
Cognigni
Graciela Estela
GE
Taraborrelli
Stefania
S
Parmegiani
Lodovico
L
Bernardi
Silvia
S
Ciampaglia
Walter
W
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004624:Embryo Transfer; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic
D006063:Chorionic Gonadotropin; D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone