title: Spontaneous clinical pregnancy following GNRH agonist trigger for final oocyte maturation and freeze-all approach: a case report.
abstract: We herein describe a 34-year old infertile woman with polycystic ovary syndrome who was underwent follicle stimulation with a gonadotrophin-releasing hormone (GnRH) agonist, and a freeze-all approach, but still conceived spontaneously without any luteal phase support and without development of ovarian hyperstimulation syndrome. The bilateral antral follicle count of the patient was 22. A fixed GnRH antagonist protocol was used. As the number of follicles wider than 11 mm in diameter on the day of stimulation was 28, the final oocyte maturation was triggered by a GnRH agonist and a freeze-all approach was taken. Although no luteal phase support was used after trigger, the patient conceived spontaneously. In conclusion, the endogenous LH level during the luteal phase may be sufficiently high in selected cases to rescue some of the corpora lutea even when a GnRH agonist has been administered for final oocyte maturation. When a freeze-all approach is taken to avoid ovarian hyperstimulation syndrome, couples should be strictly advised to refrain from sexual intercourse after oocyte retrieval.
authors.affiliation: Anatolia Women's Health and IVF Center, Ankara, Turkey; Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. Electronic address: hyarali@hacettepe.edu.tr.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yarali
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Gürkan
authors.initials: G
authors.lastname: Bozdag
authors.affiliation: Anatolia Women's Health and IVF Center, Ankara, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Polat
authors.affiliation: Anatolia Women's Health and IVF Center, Ankara, Turkey.
authors.forename: Irem
authors.initials: I
authors.lastname: Yarali
authors.affiliation: Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
mesh_terms: D000328:Adult; D003338:Corpus Luteum / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000737:chemistry*; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008183:Luteal Phase; D054315:Oocyte Retrieval; D009865:Oocytes / Q000166:cytology*; D009866:Oogenesis; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000628:therapy*; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone
keywords: GnRH agonist triggering; in vitro fertilization; luteal phase support; pregnancy