Successful live birth in a woman with resistant ovary syndrome treated with letrozole and HMG: A case report

Medicine (Baltimore). 2020 May;99(20):e20199. doi: 10.1097/MD.0000000000020199.

Abstract

Introduction: Resistance ovary syndrome (ROS) is a disease characterized by hypergonadotropic amenorrhea but with normal ovarian reserve. Currently, its pathogenesis is still unclear and the treatment methods are complex. Nevertheless, there are evident negative effects of this disease on females' physical and mental health such as gonadal dysplasia, infertility, anxiety, and depression. This article reports a case of successful ovulation induction and pregnancy with letrozole combined with HMG. This can provide clinical treatment guidelines for the disease.

Patient concerns: The patient underwent several hormone replacement cycles and ovulation induction cycles. But the dominant follicles were not extracted even after using large doses of gonadotropin.

Diagnosis: Resistant ovary syndrome; Primary infertility INTERVENTIONS:: Larger doses of letrozole combined with HMG were injected to stimulate ovulation and sensitize the ovaries during menstruation. This helped to examine the peripheral effects of letrozole in relation to gonadotropin.

Outcomes: The patient displayed a dominant follicular growth and notable ovulation which resulted in a full-term pregnancy and successful delivery.

Conclusions: The resistance ovary syndrome (ROS) can be treated and the findings from this case provides a possible treatment for ROS patients with infertility.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aromatase Inhibitors / administration & dosage
  • Aromatase Inhibitors / therapeutic use*
  • Drug Therapy, Combination / methods
  • Female
  • Gonadotropins / therapeutic use
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / drug therapy
  • Injections, Intramuscular / methods
  • Letrozole / administration & dosage
  • Letrozole / therapeutic use*
  • Live Birth
  • Ovulation / drug effects
  • Ovulation / physiology
  • Ovulation Induction / methods
  • Pregnancy
  • Primary Ovarian Insufficiency / drug therapy*
  • Treatment Outcome

Substances

  • Aromatase Inhibitors
  • Gonadotropins
  • Letrozole