Ovarian hyperstimulation syndrome following GnRH agonist trigger for final follicular maturation in a patient undergoing random start ovarian stimulation for egg-donation cycle with an inadvertent concomitant early pregnancy

Abstract

We report the first case of OHSS following GnRH agonist trigger for final follicular maturation in random start ovarian stimulation for egg-donation cycles during inadvertent concomitant early pregnancy. As an additional note, the sustained activity exerted by the increasing endogenous hCG production seemed to be responsible for the suboptimal performance in terms of oocyte yield in the current case. OHSS can occur in random-start stimulations protocols even after the use of a GnRH agonist for triggering in case of concomitant unnoticed early pregnancy especially if stimulation is commenced in the periovulatory/luteal phase. The present case report introduces a note of extreme caution when proceeding with this protocol in an otherwise fertile population (egg-donors, elective or oncologic oocyte cryopreservation).

摘要

我们报告了第一例在无意中伴随早孕的捐赠周期中随机启动卵巢刺激, 触发GnRH激动剂以最终卵泡成熟后的OHSS。另外值得注意的是, 在目前的情况下, 内源性hCG水平增加所产生的持续活性似乎是造成卵母细胞产量欠佳的原因。OHSS可在随机启动刺激方案中发生, 即使在使用GnRH激动剂触发未被注意的早期妊娠的情况下, 尤其是在刺激开始于周期/黄体期时。本病例报告介绍了在其他可育人群（卵子供体、选择性或肿瘤性卵母细胞冷冻保存）中进行此方案时应特别注意的事项。

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:

• Random-start
• ovarian stimulation
• GnRH agonist trigger
• OHSS
• pregnancy

Disclosure statement

The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. No external funding was sought or obtained for this study. All authors agree for the submission of the manuscript.