Purpose: To determine if a successful pregnancy is possible in a woman aged 45 with elevated day 3 serum follicle stimulating hormone (FSH), a short follicular phase, and failure to attain a mature follicle before ovulating.
Methods: Ethinyl/estradiol (20 microg daily) was given from day 2 of the menstrual cycle until follicular maturation was attained. Progesterone support of 200 mg twice daily progesterone vaginal suppositories were given in the luteal phase.
Results: A mature follicle was attained on day 12 with a serum estradiol of 335 pg/ml. Successful pregnancy and delivery were attained.
Conclusions: This is the third reported case of a successful pregnancy in a woman > or = 45 years old with hypergonadotropism, and the first one reported that was also complicated by a short follicular phase.