Random start controlled ovarian hyperstimulation for fertility preservation during incidental pregnancy: a case report of blastocyst vitrification from in vitro matured oocytes

Abstract

Here, we present a diffuse large B cell lymphoma patient admitted for fertility preservation before cancer therapy and whose pregnancy was recognized incidentally just after the start of random start controlled ovarian stimulation (RSCOH) during the stimulation cycle. Despite an optimal homogenous growth of follicle cohort, majority of the retrieved oocytes were immature after GnRHa trigger. Possible effects of extremely high serum progesterone and/or β-hCG levels on oocyte in vivo maturation are discussed with the surprising high rate of in vitro maturation and subsequent good embryo development. It seems that in case of need for pregnancy termination as a result of an urgent cancer therapy, RSCOH can be started and patients may benefit from overnight in vitro maturation of oocytes.

摘要

在此, 我们报告一例弥漫性大B细胞淋巴瘤患者, 在癌症治疗前因保留生育能力而入院, 然后在随机启动控性制卵巢刺激（RSCOH）后偶然发现该患者已经怀孕。尽管卵泡群的均匀生长是理想的, 但大多数获得的卵母细胞在GnRHa触发后仍未成熟。这可能与妊娠后体内高水平的孕酮和β-HCG对卵母细胞体内成熟有影响。看来, 如果因癌症急需治疗而需要终止妊娠后可以启动RSCOH, 患者的卵母细胞的在体外能够很快发育成熟。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Pregnancy
• progesterone
• random start controlled ovarian hyperstimulation

Disclosure statement

The authors of this article report no conflicts of interest.