title: Effective ovarian stimulation in a patient with resistant ovary syndrome and antigonadotrophin antibodies.
abstract: OBJECTIVE
  We report on a successful ovarian stimulation and pregnancy in a patient with 'resistant ovary syndrome' (ROS) and antigonadotrophin antibodies. ROS is characterized by high endogenous gonadotrophins, low estradiol, normal ovarian antral follicle counts and normal antimuellerian hormone values.
  
  
  METHODS
  After cyclical hormone treatment, downregulation with GnRH analogue and ICSI procedure followed. Granulosa cells were treated with LH, FSH or hMG and expression of receptors for FSH, LH, oestrogen receptor beta (ERb) and progesterone receptor A (PR-A) was determined. Serum of the patient was analysed for antibodies directed against hMG.
  
  
  RESULTS
  After fertilization of ten metaphase II oocytes and transfer of two blastocysts, a singleton pregnancy was established. Stimulation of granulosa cells with FSH, LH and hMG upregulated ERb and PR-A. Dot blot analysis showed strong reactivity with hMG but not with recFSH.
  
  
  CONCLUSIONS
  This patient with normal expression of gonadotrophin receptors showed antibodies directed to hMG but not to recFSH.
authors.affiliation: Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany; Department of Gynecology and Obstetrics, Campus Innenstadt, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Rogenhofer
authors.forename: Roman
authors.initials: R
authors.lastname: Pavlik
authors.forename: Udo
authors.initials: U
authors.lastname: Jeschke
authors.forename: Gabriele
authors.initials: G
authors.lastname: Wypior
authors.forename: Robert
authors.initials: R
authors.lastname: Ochsenkühn
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Thaler
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008596:Menotropins / Q000276:immunology*; D010062:Ovulation Induction; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008596:Menotropins
keywords: Antigonadotrophin antibodies; ICSI; hMG; human menopause gonadotropin; hypergonadotropic amenorrhoea; resistant ovary syndrome