Successful live birth in a woman with resistant ovary syndrome following in vitro maturation of oocytes

Abstract

BackgroundResistant ovary syndrome (ROS) is a rare endocrine disorder characterized with hypergonadotrophic hypogonadism. Infertility is a common complaint of woman presenting with ROS, and little progress has been made in term of reproduction with the patient’s own gamete. So far only one case report of live birth has been reported after in vitro maturation (IVM) of oocytes in a patient suffering from ROS in 2013.Case presentationA secondary infertile woman of 33 years-old was manifested with oligomenorrhea and markedly increased gonadotropin levels around postmenopausal range, but had normal antral follicle count, normal serum inhibin B and anti-Müllerian hormone levels. She had normal karyotype of 46,XX and normal thyroid function. There were no abnormal findings in some autoantibody assays and FSH receptor sequencing. After oral contraceptive pills combined with triptorelin depot were administered, her gonadotropin levels reduced but it showed no response to high doses of exogenous gonadotropins (hp-HMG 300IU/d for 15 days). Then endometrium was prepared with estradiol valerate and IVM from small antral follicles were performed. Five immature oocytes were retrieved. Twenty-four hours after IVM culture, 3 oocytes matured to metaphase II stage and were inseminated by intracytoplasmic sperm injection using her husband’s sperm. Two top-quality embryos were transferred and one embryo was cryopreserved. The patient got pregnant and delivered a healthy boy at term.ConclusionIVM using their own oocytes could be an available treatment for infertile women with ROS.

Two Cases of Primary Ovarian Insufficiency Accompanied by High Serum Anti-Müllerian Hormone Levels and Preservation of Ovarian Follicles

“…Gonadotropin-resistant ovary syndrome (gonadotropin-ROS) or ROS, first described by Jones and De Moraes-Ruehsen [14] in 1969, is known to be one of the causes of ovarian failure leading to primary or secondary amenorrhea. The presence of a normal amount of antral follicles is a criterion that distinguishes ROS from the classical POI [14,15]. Besides an age-compatible number of small antral follicles, additional cardinal clinical features of ROS are normal chromosome, elevated gonadotropin levels of menopausal range, and unresponsiveness to gonadotropin stimulation [15], all of which are consistent with our cases.…”

Pregnancy following diagnosis of premature ovarian insufficiency: a systematic review

“…In 5-10% of cases of POI, however, pregnancy can occur naturally, with hormone replacement therapy (HRT), IVF, or, more recently, in-vitro maturation (IVM) or with stem cell therapy . Numerous case reports also support this statement (TABLE 1) (Check et al, 2000;Nawroth et al, 2000;Zargar et al, 2000;Takahashi et al, 2001;Fernandes, 2002;Hershlag and Schuster 2002;Chao et al, 2003;Eldeen and Fawzi, 2003;Muller et al, 2003;Patel et al, 2003;Aslam et al, 2004;Menezo et al, 2004;Vital-Reyes et al, 2004;Corrigan et al, 2005;Check and Katsoff, 2006;Vandborg and Lauszus, 2006;Liza et al, 2008;Dragojevic-Dikic et al, 2009;Genazzani, 2009;Neves-e-Castro, 2009;Selvaraj et al, 2010;Chen and Chen, 2011;Ebrahimi et al, 2011, Ferrau et al, 2011Laway et al, 2011;Tartagni et al, 2011;Ghazeeri and Awwad, 2012;Grynberg et al, 2013;Maruyama et al, 2013;Soave et al, 2013;Tsuji et al, 2013;Rogenhofer et al, 2014;Warenik-Szymankiewicz and Slopien 2014;Roth and Alvero, 2014;Li et al, 2016).…”

Oocyte in vitro maturation: A sytematic review

“…Papers on IVM before 2009 showed low implantation and pregnancy rates but after the publication of Pak et al ( 32 ) , the results were comparable with IVF. PCOS and OHSS are the main indications of IVM; however, IVM may also be used in cases of resistant ovary syndrome and fertility preservation as uncommon indications ( 33 , 34 , 35 ) . Child et al ( 36 ) studied the impact of IVM on PCO, PCOS, and unstimulated normal ovaries and concluded that hCG priming in all three groups had similar high maturation, fertilization, and developmental potential.…”