Dados do Trabalho

Title

Overlapping doses of corifollitropin alfa in a progestin-primed regimen may be an interesting advance towards a patient-extremely friendly controlled ovarian stimulation: a case report.

Objective

To report the results of controlled ovarian stimulation using ovelapped doses of corifollitropin alfa, in a progestin-primed cycle, for social egg freezing.

Methods

Case report.

Results

Nuligesta, 37 years old, with regular menstrual cycles, 57kg, body mass index 20.19 k/m2, sought the private clinic for social egg freezing. No alterations were identified in pre-treatment complementary exams and the ultrasonographic antral follicle count was 17. The patient was stimulated following a progestin-primed ovarian stimulation protocol, using corifolitropin alfa (CFA), 100 mcg, on the third day (D3) of the menstrual cycle. A new 100 mcg dose of CFA was administered on treatment day 5 (D5), according to the observation of pharmacokinetic curves described in CFA validation studies. Pituitary supression was also initiated on D5, using desogestrel (DSG), 75 mcg/day. On D11, follicular maturation was triggered with triptorelin acetate, 0.2 mg (two injections of 0.1 mg).Abdominal distention and edema of the lower extremities were the only adverse effects reported, but they were well tolerated without specific medication. Follicular aspiration was performed 36 hours after trigger, yielding 12 oocytes, of which 10 in metaphase II (vitrified), 1 in metaphase 1 and 1 in prophase I (discarded).

Conclusion

Overlapped doses of CFA in a DSG-primed ovarian stimulation protocol demonstrated to be a safe, efficacious, well-tolerated, and cost-effective, being an extremely friendly treatment option for social egg freezing. Further well-designed studies are necessary for validation.

Keywords

Social egg freezing, Social fertility preservation, Patient-friendly, Progestin-primed ovarian stimulation, Vitrification, Oocyte cryopreservation