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Assisted reproduction treatment in severe myasthenia gravis
Giuseppe Ricci1, Michela De Santis, Gloria Pagnini
1Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Institute of Child Health, IRCCS Burlo Garofolo and University of Trieste, Trieste, Italy. ricci@burlo.trieste.it
Objective:
To report a case of a patient with a severe myasthenia gravis (MG) who underwent controlled ovarian hyperstimulation for assisted conception.
Design:
Case report and literature review.
Setting:
Tertiary infertility center.
Patient(S):
A 40-year-old woman affected by severe MG.
Intervention(S):
Controlled ovarian hyperstimulation, oocyte retrieval, intracytoplasmic sperm injection (ICSI) procedure for severe oligoastenozoospermia.
Main Outcome Measure(S):
Short- and long-term effects of assisted reproduction treatment (ART) on the clinical course of MG.
Result(S):
A total of four ICSI cycles were performed. In the third cycle, a pregnancy was achieved, but a spontaneous abortion occurred. No changes in MG therapy were necessary, neither before nor after the treatment. All procedures were well tolerated and no exacerbations of symptoms occurred. By contrast a little, but persistent, improvement of clinical disease course was observed.
Conclusion(S):
This is the first report of a patient with severe MG who underwent ART cycles. Although more patients need to be evaluated, the present case suggests that MG patients should not be excluded a priori from ART.
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