METHODS: The 30-year-old woman presented with secondary amenorrhea and infertility. Her serum FSH levels were found to be higher than normal, but in discordance with a normal anti-Müllerian hormone (AMH) level and antral follicle count. Genetic investigation found no mutations potentially affecting FSHR. With reference of previous ROS studies, the patient\'s serum was analyzed for antibodies directed against FSHR and dot blot analysis showed strong reactivity with FSHR. Then, dexamethasone was proposed to the patient, and she successfully became pregnant, finally delivering a healthy girl by caesarean section.
CONCLUSIONS: To our best knowledge, this is the first report of the successful treatment of ROS using ovarian stimulation combined with dexamethasone. In some cases of ROS, high doses of exogenous gonadotropins in combination with immunosuppressive therapy could be an effective approach.
方法:30岁女性出现继发性闭经和不孕症。发现她的血清FSH水平高于正常水平,但与正常的抗苗勒管激素(AMH)水平和窦卵泡计数不一致。遗传调查未发现可能影响FSHR的突变。参考以前的ROS研究,分析患者血清中针对FSHR的抗体,斑点印迹分析显示与FSHR的反应性强.然后,向患者推荐了地塞米松,她成功地怀孕了,最终通过剖腹产接生了一个健康的女孩.
结论:据我们所知,这是首次报道卵巢刺激联合地塞米松成功治疗ROS.在某些情况下,ROS大剂量外源性促性腺激素联合免疫抑制治疗可能是一种有效的方法。