cetrorelix and Syndrome

To report a case of empty follicle syndrome (EFS) after human error occurring in hCG administration and discuss the specific management of this event in a GnRH antagonist cycle.. Case report.. A university hospital.. A 27-year-old woman admitted for a first oocyte retrieval resulting in empty follicle syndrome. The cause was the lack of administration of hCG injection 36 hours earlier.. Serial measurements of hCG, LH, and P.. Because no injection of GnRH antagonist had been given for 2 days, the occurrence of endogenous LH surge was assessed by measurement of serum LH, P, and E(2). In the absence of any spontaneous LH surge, EFS was successfully treated by administering 250 microg of recombinant hCG in the evening of the first failed ovarian puncture and rescheduling the second oocyte retrieval 36 hours later. Four oocytes were retrieved and two resulting embryos were transferred. Pregnancy was obtained and patient gave birth to a healthy male baby at term.. Our case is the first report of pregnancy obtained after a successful treatment of EFS in a GnRH antagonist cycle. In contrast to GnRH agonist down-regulated cycles, the management of EFS in GnRH antagonist cycles has to take into account the possible occurrence of spontaneous endogenous LH surge.

Topics: Adult; Female; Gonadotropin-Releasing Hormone; Humans; Medical Errors; Oocyte Retrieval; Ovarian Diseases; Pregnancy; Pregnancy Outcome; Syndrome

The objective of this study was to demonstrate the efficacy of cetrorelix, a GnRH antagonist, in rats with experimentally induced ovarian remnant syndrome.. 25 Wistar female rats at seven to eight weeks of age and weighing 200-250 g were used. The rats were randomly divided into five groups: the first group was used as a control group; the second and third groups underwent a sham operation; and the fourth and fifth groups underwent bilateral hemiovariectomy. At the first proestrus detected by vaginal cytology from postoperative day 2, the animals in groups 1, 2 and 5 received placebo and the animals in groups 3 and 4 received cetrorelix subcutaneously. In the study, the Kruskal-Wallis analysis of variance was used for comparison of the results of vaginal irrigation, histopathblogical examination, and of blood FSH and LH values, and the Mann Whitney U-test was used for determination of the differences between the groups.. It was determined that according to vaginal cytology results, estrus-like cytological changes disappeared in a shorter time and according to histopathology results, the number of follicles were fewer in the ovarian remnant syndrome-induced and cetrorelix-injected group 4 (p < 0.05), but there was no difference between the groups for FSH and LH concentrations.. Ovarian remnant syndrome is a complication of bilateral ovariohysterectomy. In cases with this syndrome, certain treatment is possible with re-operation. However, it may not always be possible to perform an operation, or even if operated, it is difficult to determine the place of the residual ovarian tissue. In this study, it was determined that the use of cetrorelix as a GnRH antagonist in rats with ovarian remnant syndrome reduced the duration of estrogenic affect.

Topics: Animals; Disease Models, Animal; Estrous Cycle; Female; Gonadotropin-Releasing Hormone; Ovariectomy; Ovary; Rats; Syndrome