An ongoing pregnancy from two waves of follicles developing during a long follicular phase of the same cycle.
OBJECTIVE
To report an ongoing pregnancy after in vitro fertilization (IVF) with ovarian stimulation using a gonadotropin-releasing hormone (GnRH) antagonist that resulted in two waves of follicular growth.


METHODS
Case report.


METHODS
University of Toronto affiliated infertility clinic.


METHODS
A 33-year-old woman with a 3-year history of secondary infertility.


METHODS
In vitro fertilization and embryo transfer.


METHODS
Ongoing pregnancy.


RESULTS
This patient successfully conceived after the GnRH antagonist-induced demise of the first cohort of follicles and the emergence of a second wave of follicles followed by oocyte retrieval on cycle day 30 and fresh embryo transfer.


CONCLUSIONS
This case report is consistent with previous observations of multiple waves of follicle recruitment and growth per cycle. The window of implantation may not be adversely affected by prolonged or even variable estrogen exposure in the follicular phase of the cycle.
Toronto Centre for Advanced Reproductive Technology, Toronto, Ontario, Canada.
Yaakov
Y
Bentov
Navid
N
Esfandiari
Asli
A
Gokturk
Eliezer
E
Burstein
Ofer
O
Fainaru
Robert F
RF
Casper
D000328:Adult; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005498:Follicular Phase / Q000187:drug effects / Q000502:physiology*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000494:pharmacology; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects / Q000254:growth & development*; D010060:Ovulation / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone