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CASE REPORT
Year : 2015  |  Volume : 10  |  Issue : 3  |  Page : 99-100

Inadvertent premature human chorionic gonadotropin administration does not prevent folliculogenesis and in vitro fertilization


Department of Obstetrics and Gynecology, Rambam Health Care Campus, The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel

Correspondence Address:
Zeev Blumenfeld
Department of Obstetrics and Gynecology, Reproductive Endocrinology, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, 8 Haaliyah St, Haifa 31096
Israel
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DOI: 10.4103/1858-5000.167872

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A 41.9-year-old patient, G 10101 was referred to fertility preservation 2 weeks before chemotherapy, due to metastatic liver malignancy. Her past history was positive for laparoscopic sigmoidectomy, 5 years ago due to the stage I colon carcinoma. She has undergone a normal vaginal delivery in her previous marriage, 15 years ago and a septic abortion, 2 days after amniocentesis, a year ago, in her current marriage. Despite high follicle-stimulating hormone (FSH), she started ovarian stimulation with high dose recombinant gonadotropins and gonadotropin-releasing hormone antagonist, on the 6 th day of her cycle, in the presence of two antral follicles. By mistake, she injected 250 μg of human chorionic gonadotropin (hCG), in addition to 450 units FSH/luteinizing hormone (Pergoveris, Merck Serono) on the 1 st day of stimulation. The Controlled Ovarian Stimulation (COS) continued and on the 18 th cycle day, 250 μg of hCG was administered and 35.5 h afterward, two metaphase II ova were retrieved by vaginal follicular aspiration. The ova have undergone intracytoplasmic sperm injection, and fertilization was documented after 20 h, and two embryos were cryopreserved on the 2 nd day. This unusual case suggests that premature exposure to supraphysiologic concentrations of hCG and progesterone, may not interfere with normal folliculogenesis, oocyte maturation, and in vitro fertilization.


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