Ovarian hyperstimulation after a short course of an oral contraceptive in a patient with premature ovarian failure

Fertil Steril. 2008 Nov;90(5):2004.e15-7. doi: 10.1016/j.fertnstert.2008.03.050. Epub 2008 Jun 12.

Abstract

Objective: To report a patient with premature ovarian failure who, after discontinuing a short course of therapy with an oral contraceptive, demonstrated clinical and biochemical evidence of ovarian hyperstimulation.

Design: Case report.

Setting: Reproductive Center at a university hospital.

Patient(s): 31-year-old woman with premature ovarian failure.

Intervention(s): Triggered ovulation using recombinant human chorionic gonadotropin (hCG).

Main outcome measure(s): Follicle sizes documented by transvaginal ultrasound and corresponding serum estradiol levels.

Result(s): Hyperstimulated ovaries, documented by pelvic ultrasound, demonstrated lead follicles of 16, 22, 27, and 46 mm in average diameters. The serum estradiol level was 979 pg/mL with a serum progesterone of 0.87 ng/mL. Five days after triggered ovulation with recombinant hCG, serum progesterone levels rose to 13.8 ng/mL.

Conclusion(s): Ovarian hyperstimulation may occur after brief gonadotropin suppression in women with premature ovarian failure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chorionic Gonadotropin / therapeutic use
  • Contraceptives, Oral, Hormonal / adverse effects*
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone, Human / blood
  • Humans
  • Ovarian Hyperstimulation Syndrome / chemically induced*
  • Ovarian Hyperstimulation Syndrome / drug therapy
  • Ovarian Hyperstimulation Syndrome / metabolism
  • Ovarian Hyperstimulation Syndrome / pathology
  • Ovary / diagnostic imaging
  • Ovary / drug effects*
  • Ovary / metabolism
  • Ovulation Induction
  • Primary Ovarian Insufficiency / drug therapy*
  • Progesterone / blood
  • Recombinant Proteins / therapeutic use
  • Ultrasonography

Substances

  • Chorionic Gonadotropin
  • Contraceptives, Oral, Hormonal
  • Follicle Stimulating Hormone, Human
  • Recombinant Proteins
  • Progesterone
  • Estradiol