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Abstract：
OBJECTIVE: We report a successful live birth after oocytes in vitro maturation (IVM) and fresh embryo transfer in a patient with autoimmune premature ovarian failure (POF) and performed a review of the literature of livebirths obtained after oocytes IVM treatment in this indication.
METHODS: The patient was a 24-year-old woman with autoimmune POF diagnosed post-partum, who developed autoimmune polyglandular syndrome with serum anti-ovarian and anti-21-hydroxylase antibodies. The patient had typical symptoms of POF: secondary amenorrhea with hypoestrogenism, elevated gonadotropins and infertility; however, the serum anti-Müllerian hormone level and total antral follicle count remained normal. IVM of immature oocytes was performed after the administration of 150 IU highly purified human menopausal gonadotropin for three consecutive days and an injection of 10,000 IU human chorionic gonadotropin to trigger ovulation.
RESULTS: The six oocyte-cumulus complexes collected matured in vitro. After intracytoplasmic sperm injection (ICSI), five embryos were obtained. Pregnancy was achieved after the fresh transfer of two embryos and appropriate endometrial preparation. A normal female child was delivered following a 37-weeks pregnancy characterized by the onset of adrenal insufficiency and unstable diabetes.
CONCLUSIONS: We report a successful livebirth after IVM treatment in a patient with autoimmune premature ovarian failure (POF). Management of reproductive age women with autoimmune pathology requires fertility counseling. Early diagnosis of autoimmune POF is important for early conception and oocyte preservation, because the only other option at present is ovum donation.
METHODS: The patient was a 24-year-old woman with autoimmune POF diagnosed post-partum, who developed autoimmune polyglandular syndrome with serum anti-ovarian and anti-21-hydroxylase antibodies. The patient had typical symptoms of POF: secondary amenorrhea with hypoestrogenism, elevated gonadotropins and infertility; however, the serum anti-Müllerian hormone level and total antral follicle count remained normal. IVM of immature oocytes was performed after the administration of 150 IU highly purified human menopausal gonadotropin for three consecutive days and an injection of 10,000 IU human chorionic gonadotropin to trigger ovulation.
RESULTS: The six oocyte-cumulus complexes collected matured in vitro. After intracytoplasmic sperm injection (ICSI), five embryos were obtained. Pregnancy was achieved after the fresh transfer of two embryos and appropriate endometrial preparation. A normal female child was delivered following a 37-weeks pregnancy characterized by the onset of adrenal insufficiency and unstable diabetes.
CONCLUSIONS: We report a successful livebirth after IVM treatment in a patient with autoimmune premature ovarian failure (POF). Management of reproductive age women with autoimmune pathology requires fertility counseling. Early diagnosis of autoimmune POF is important for early conception and oocyte preservation, because the only other option at present is ovum donation.
摘要：
目的：我们报道了一名自身免疫性卵巢早衰（POF）患者在卵母细胞体外成熟（IVM）和新鲜胚胎移植后成功的活产，并对该适应症中卵母细胞IVM治疗后获得的活产文献进行了综述。
方法：患者是一名24岁的女性，产后诊断为自身免疫性POF，患有血清抗卵巢和抗21-羟化酶抗体的自身免疫性多腺综合征。患者有典型的POF症状：继发性闭经伴雌激素减少，促性腺激素升高和不育;然而，血清抗苗勒管激素水平和总窦卵泡计数保持正常。在连续三天给予150IU高度纯化的人绝经促性腺激素并注射10,000IU人绒毛膜促性腺激素以触发排卵后，进行未成熟卵母细胞的IVM。
结果：收集的6个卵母细胞-卵丘复合体在体外成熟。卵胞浆内单精子注射（ICSI）后，获得5个胚胎。在两个胚胎的新鲜移植和适当的子宫内膜准备后实现妊娠。妊娠37周后分娩了一名正常的女性儿童，其特征是肾上腺功能不全和不稳定的糖尿病。
结论：我们报告了一例自身免疫性卵巢早衰（POF）患者在IVM治疗后成功的活产。具有自身免疫性病理学的育龄妇女的管理需要生育咨询。自身免疫性POF的早期诊断对于早期受孕和保存卵母细胞具有重要意义。因为目前唯一的选择是卵子捐赠。
方法：患者是一名24岁的女性，产后诊断为自身免疫性POF，患有血清抗卵巢和抗21-羟化酶抗体的自身免疫性多腺综合征。患者有典型的POF症状：继发性闭经伴雌激素减少，促性腺激素升高和不育;然而，血清抗苗勒管激素水平和总窦卵泡计数保持正常。在连续三天给予150IU高度纯化的人绝经促性腺激素并注射10,000IU人绒毛膜促性腺激素以触发排卵后，进行未成熟卵母细胞的IVM。
结果：收集的6个卵母细胞-卵丘复合体在体外成熟。卵胞浆内单精子注射（ICSI）后，获得5个胚胎。在两个胚胎的新鲜移植和适当的子宫内膜准备后实现妊娠。妊娠37周后分娩了一名正常的女性儿童，其特征是肾上腺功能不全和不稳定的糖尿病。
结论：我们报告了一例自身免疫性卵巢早衰（POF）患者在IVM治疗后成功的活产。具有自身免疫性病理学的育龄妇女的管理需要生育咨询。自身免疫性POF的早期诊断对于早期受孕和保存卵母细胞具有重要意义。因为目前唯一的选择是卵子捐赠。
