A successful pregnancy by utilization of gradually ıncreasing low dose gonadotrophin stimulation in a modified natural cycle in vitro fertilization procedure: case report

Modifiye doğal siklus in vitro fertilizasyon tedavisi (MDS-İVF) tedaviye kötü cevap veren hastalar için, özellikle de kötü ovar- yan rezerve sahip genç hastalar için daha etkin bir metod ola- bilir. Otuzdört yaşındaki primer infertil bir kadın iki ay önceki bir İVF- ET işlemi esnasında yapılan kontrollü ovaryan hiperstimülas- yona kötü over cevabı ve siklus iptali hikayesi ile başvurmuş- tur. İntrasitoplazmik sperm enjeksiyonu ile birlikte yapılan MDS-İVF tedavisi esnasında, eşlik eden cetrorelix tedavisine ek olarak üç gün boyunca dereceli olarak artan dozlarda hMG (toplam 675 İU) uygulanmıştır. Ovulasyon tetiklemesini taki- ben, bir oosit toplanmış ve hastaya iyi kalitede bir ikinci gün embriyosu transfer edilmiştir. Altıncı gebelik haftasında ultra- sonografi ile bir klinik gebelik tespit edilmiştir. Özellikle stimülasyona kötü cevap veren hastalar için uygun bir tedavi şekli olarak MDS-İVF tedavisinin temel avantajları em- briyo transferi başına kabul edilebilir gebelik oranları, düşük ilaç bedeli, göreceli olarak düşük komplikasyon riski ve yüksek hasta kabul edilebilirliğidir.

Kademeli olarak artan düşük doz gonadotropin verilerek yapılan bir modifiye doğal siklus in vitro fertilizasyon işleminde başarılı bir gebelik: olgu sunumu

The modified natural cycle in vitro fertilization (MNC-IVF) treatment can be a promising method for poor responder patients especially in young patients with poor ovarian reserve. A 34-year-old primary infer- tile woman presented with a history of poor ovarian response and cycle cancellation following controlled ovarian hyperstimulation during an IVF-ET procedure two months ago. During MNC-IVF treatment with intracytoplasmic sperm injection (ICSI), gradually increasing doses of hMG for three days (totally 675 IU) have been administered accompanied by daily 0,25 mg cetrorelix. Following ovulation triggering, one oocyte was picked up and a good quality (grade 1) embryo was transferred on day 2. A clinical preg- nancy was established with ultrasonography on sixth weeks of gestation. Acceptable pregnancy rates per embryo transfer, low medication cost, relatively low risk of complications and higher patient accept- ability are the main advantages of MNC-IVF treatment as a feasible treatment option especially for poor responder patients.

Kaynakça

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