title: First live birth following IVF-embryo transfer and use of GnRHa alone for ovarian stimulation.
abstract: Several case reports have shown that some patients may develop ovarian cysts or ovarian hyperstimulation syndrome following the administration of gonadotrophin-releasing hormone agonist (GnRHa). This is the first report of a live birth following ovarian stimulation and IVF-embryo transfer using sole administration of GnRHa as part of the short protocol. The 31-year-old woman was referred to IVF because of severe male factor. Following spontaneous menses, ovulation induction was started by administering a conventional flare-up regimen (triptorelin 0.1 mg) on day 1 of the cycle. On day 3, the oestradiol concentration was 444 pg/ml and the progesterone concentration was 0.3 ng/ml. On day 4, about 10 follicles, 8-10 mm in size, were detected in each ovary, and the oestradiol concentration rose to 704 pg/ml (progesterone was unchanged). Surprisingly, on day 9, the follicles were 18-19 mm in diameter, oestradiol had increased to 3678 pg/ml and progesterone was now 2.88 ng/ml. Informed consent was obtained for administering human chorionic gonadotrophin and for performing ovum retrieval 36 h later. Nineteen MII oocytes were retrieved, and all were fertilized, yielding high-quality embryos. Two embryos were transferred, and the patient conceived and recently gave birth to a healthy singleton.
authors.affiliation: The Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel. azemf@tasmc.health.gov.il
authors.forename: Foad
authors.initials: F
authors.lastname: Azem
authors.forename: Beni
authors.initials: B
authors.lastname: Almog
authors.forename: Dalit
authors.initials: D
authors.lastname: Ben-Yosef
authors.forename: Rita
authors.initials: R
authors.lastname: Kapustiansky
authors.forename: Israel
authors.initials: I
authors.lastname: Wagman
authors.forename: Ami
authors.initials: A
authors.lastname: Amit
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology*; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy
chemical_list: D007987:Gonadotropin-Releasing Hormone