关键词: GnRH agonist IVF hCG trigger immature oocytes unexpected response

Mesh : Adult Chorionic Gonadotropin / genetics pharmacology therapeutic use Drug Resistance, Multiple Female Fertility Agents, Female / pharmacology therapeutic use Gonadotropin-Releasing Hormone / agonists metabolism Humans In Vitro Oocyte Maturation Techniques Infertility, Female / etiology metabolism pathology therapy Oogenesis / drug effects Ovary / drug effects metabolism pathology Ovulation Induction Polycystic Ovary Syndrome / physiopathology Recombinant Proteins / pharmacology therapeutic use Sperm Injections, Intracytoplasmic Treatment Outcome Young Adult

来  源:   DOI:10.1080/09513590.2017.1369514   PDF(Sci-hub)

Abstract:
The purpose of ovarian stimulation in IVF is to recover mature oocytes at metaphase II stage which are capable of fertilization either when mixed with sperm or after ICSI. However, there have been instances when even after controlled ovarian stimulation (COS) and correct administration of human chorionic gonadotrophin (hCG) trigger for final oocyte maturation, the oocytes were found to be arrested at germinal vesicle (GV) or metaphase I (MI) stage. Similar dilemma is faced in cases of empty follicle syndrome (either genuine or due to inadequate response), however, in this condition, there is no retrieval of oocytes despite presence of mature looking follicles. We present an interesting case where despite presence of normally growing follicles and documentation of correct response to trigger and rise in estradiol levels, two subsequent IVF cycles; one triggered with recombinant hCG and second with GnRH agonist, hCG failed to yield mature oocytes. Both cycles yielded expected number of oocytes but all at immature MI stage even after dual trigger.
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