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Ovarian hyperresponse to luteal phase GnRH-agonist administration

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Herein we report a case of ovarian hyperresponse after luteal phase GnRH-agonist administration in a woman planning to undergo ovarian stimulation for IVF in a long GnRH-agonist protocol.

Materials and methods

A normogonadotropic 25-year-old woman undergoing ICSI treatment for male factor infertility underwent three cycles of controlled ovarian stimulation, two in a GnRH-antagonist protocol, one in a long luteal GnRH-agonist protocol.

Results

In the first GnRH-antagonist cycle, ovarian stimulation was performed with 150 IE recombinant FSH and 22 oocytes were retrieved. In the second GnRH-antagonist cycle using the same protocol, six oocytes were retrieved. The estradiol levels on the day of hCG administration were 3,692 and 3,209 pg/ml, respectively. In a third cycle, 3.75 mg triptorelin was administered in the luteal phase and the patient showed ovarian hyperresponse to the endogenous gonadotropin flare with estradiol levels of 19,102 pg/ml, abdominal distension and discomfort, and massive bilateral ovarian enlargement (total ovarian volume 268 cm3). Ovarian cysts persisted for 4 weeks and necessitated cyst aspiration before further treatment.

Conclusion

The flare-up effect of GnRH-agonist administration can, in rare cases, cause massive ovarian hyperresponse with associated health risks and significant postponement of treatment.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Universitaet zu Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Marion Depenbusch, Klaus Diedrich & Georg Griesinger

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  1. Marion Depenbusch
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  2. Klaus Diedrich
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  3. Georg Griesinger
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Corresponding author

Correspondence to Georg Griesinger.

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Depenbusch, M., Diedrich, K. & Griesinger, G. Ovarian hyperresponse to luteal phase GnRH-agonist administration. Arch Gynecol Obstet 281, 1071–1072 (2010). https://doi.org/10.1007/s00404-009-1309-4

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  • DOI: https://doi.org/10.1007/s00404-009-1309-4

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