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[Ovarian hyperstimulation induced by a GnRH agonist. About one case]
R Naifer1, M Ajina, G Merdassi
1Service de cytogénétique et biologie de la reproduction, CHU Farhet-Hached, Sousse, Tunisie.
Gynecologie, Obstetrique & Fertilite
|December 7, 2005
Summary
Ovarian hyperstimulation syndrome (OHSS) is a rare complication of GnRH agonist treatment for infertility. This case highlights a paradoxical ovarian response to pituitary desensitization, suggesting a potential direct agonist effect.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
- Ovarian Physiology
Background:
- Gonadotropin-releasing hormone (GnRH) agonists are used in assisted reproductive technologies.
- Ovarian hyperstimulation syndrome (OHSS) is a potential complication, though typically associated with gonadotropin stimulation.
- GnRH agonist-induced OHSS is exceptionally rare, with limited reported cases.
Observation:
- A 23-year-old female with primary male-factor infertility presented with OHSS 12 days after Decapeptyl (GnRH agonist) administration.
- Significant ovarian follicle development and elevated serum estradiol levels were observed.
- Ovulation was triggered with human chorionic gonadotropin (HCG), yielding 4 oocytes, 3 mature.
Findings:
- Intracytoplasmic sperm injection (ICSI) fertilization resulted in one 4-cell embryo transfer.
- No pregnancy was achieved in this instance.
- The physiopathology of GnRH agonist-induced OHSS remains unclear, with a hypothesis of direct agonist action on the ovary.
Implications:
- This case contributes to the understanding of rare OHSS etiologies.
- Further research is needed to elucidate the direct ovarian effects of GnRH agonists.
- While challenging, successful oocyte retrieval, fertilization, and embryo transfer are possible in these rare cases, though pregnancy outcomes remain limited.