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

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.

Key Words: Premature ovarian failure, ovarian hyperstimulation, gonadotropin suppression