Ovarian stimulation for fertility preservation in an oncology patient with etonogestrel implant in place

Autor: Leslie C. Appiah, John S Rushing, Shona C. Murray, Erin H. Foust, Cassandra Roeca, Alex J. Polotsky, Kathryn L. Hassell
Rok vydání: 2021
Předmět:
Adult
Anti-Mullerian Hormone
0301 basic medicine
medicine.medical_specialty
Oocyte Retrieval
Controlled ovarian hyperstimulation
Gonadotropin-Releasing Hormone
Ovarian Hyperstimulation Syndrome
03 medical and health sciences
Follicle
Oogenesis
0302 clinical medicine
Ovulation Induction
Neoplasms
Genetics
medicine
Humans
Fertility preservation
Genetics (clinical)
Cryopreservation
Gynecology
Desogestrel
030219 obstetrics & reproductive medicine
business.industry
Fertility Preservation
Obstetrics and Gynecology
Prostheses and Implants
General Medicine
Oocyte cryopreservation
Luteinizing Hormone
Antral follicle
Oocyte
Vitrification
030104 developmental biology
medicine.anatomical_structure
Reproductive Medicine
Oocytes
Female
Follicle Stimulating Hormone
business
Luteinizing hormone
Infertility
Female
Developmental Biology
Hormone
Zdroj: J Assist Reprod Genet
ISSN: 1573-7330
1058-0468
DOI: 10.1007/s10815-020-02057-1
Popis: PURPOSE: To describe a case of a young woman who presented for fertility preservation and underwent ovarian stimulation with an etonogestrel implant in place. METHODS: A 24-year old, gravida 0, with an etonogestrel implant and newly diagnosed lower extremity sarcoma and DVT desiring oocyte cryopreservation prior to adjuvant chemotherapy and radiation. To avoid delay in her oncologic care and allow for continued use of contraception post-retrieval, the patient underwent controlled ovarian hyperstimulation (COH) without removal of the etonogestrel implant. RESULTS: Baseline labs included follicle-stimulating hormone 9 mIU/mL, luteinizing hormone 4.9 mIU/mL, estradiol 42 pg/mL, anti-Müllerian hormone 5.1 ng/mL, and antral follicle count greater than 40. The patient was placed on an antagonist protocol and stimulated with 125 IU Gonal-F and 75 IU Menopur. She received a total of 12 days of gonadotropin stimulation. On the day of trigger, her estradiol was 1472 pg/mL, lead follicle 21.5 mm with a total of 25 follicles measured > 12 mm. She was triggered with 5000 U hCG. She had a total of 23 oocytes retrieved, 17 of which were metaphase II and vitrified. CONCLUSIONS: COH and successful oocyte cryopreservation can be achieved in patients with an etonogestrel implant in situ without apparent detrimental effects to oocyte yield or maturity. Due to the etonogestrel implant’s inhibitory effects on LH, it is recommended to use an hCG trigger for final oocyte maturation.
Databáze: OpenAIRE
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