Document Detail


Successful pregnancy with frozen embryo transfer into a gestational carrier from eggs obtained from a woman in premature menopause.
MedLine Citation:
PMID:  19860356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe a unique case of a successful gestational carrier pregnancy in a woman with premature ovarian failure using her own oocyte. METHODS: Despite amenorrhea, failure to have menses to progesterone withdrawal and resistance to gonadotropin stimulation, ovulation induction was attempted by restoring down-regulated follicle stimulating hormone (FSH) receptors by lowering the elevated serum FSH and allowing stimulation by endogenous or exogenous gonadotropins. Oocyte retrieval was attempted if a mature follicle was obtained. GnRH antagonist was used to prevent premature oocyte release. Tapering prednisone was used for the first five days of the cycle due to patient's history of autoimmune disease (vasculitis and Crohn's disease). IVIG was given 8/2003 for vasculitis. RESULTS: The patient underwent a total of 19 attempted retrievals during continuous natural cycles from 3/2003 to 2/2007. Oocyte retrieval required traversing the uterus with the retrieval needle because of ovarian position after multiple surgeries for bilateral endometriomas and Crohn's disease. Empty follicle syndrome was encountered in four retrieval attempts. In 15 attempts, an oocyte was obtained. The sole attempt at natural fertilization failed. ICSI and assisted hatching were used in all subsequent attempts, and were successful in all but one attempt which led to a 3 pronuclei embryo which was discarded. The first four single embryos retrieved (7, 4, 6 cells and morula) were all A1 or A2 and transferred fresh to the patient, but no pregnancy resulted. All subsequent embryos were cryopreserved. The transfer of four embryos (6-cell and 7-cell and 3-cell and 8-cell) in two cycles to two different gestational carriers resulted in a successful delivery of a full-term healthy female infant 3.3 kg. Genetic testing confirmed maternal identity to be the patient, not the carrier. CONCLUSIONS: This is the first reported case of a successful gestational carrier pregnancy after reversing ovarian failure, inducing ovulation, and transferring a frozen-thawed embryo.
Authors:
J H Check; M Srivastava; D Brasile; J Amui; J K Choe; E Dix
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical and experimental obstetrics & gynecology     Volume:  36     ISSN:  0390-6663     ISO Abbreviation:  Clin Exp Obstet Gynecol     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-28     Completed Date:  2009-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802110     Medline TA:  Clin Exp Obstet Gynecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  154-7     Citation Subset:  IM    
Affiliation:
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. laurie@ccivf.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cryopreservation*
Embryo Transfer*
Female
Humans
Oocyte Retrieval*
Ovarian Failure, Premature
Pregnancy
Surrogate Mothers*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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