1Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
2Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Resistant ovary syndrome (ROS) is a presentation of hypergonadotrophic hypogonadism condition with very low incidence. Infertility is one of the most common complaints of women with this syndrome. We herein present a case of a 27-year-old woman with all features of secondary amenorrhea and secondary sexual characteristics. In 2018, the patient was referred to the Hazret-e-Zeinab Infertility Center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. She was diagnosed with secondary amenorrhea and increased gonadotropin secretion after menopause. However, the patient had a normal antral follicle count, anti-Müllerian hormone level, 46, XX karyotype, and thyroid function. After taking oral contraceptives her menstruation started, but she showed no response to high doses of exogenous gonadotropins. She was advised to have an embryo derived from in vitro maturation. By using patients’ own oocyte maturation, this technique could be a better treatment for infertile women with ROS. This case report is particularly interesting due to the rarity of its prevalence and similarity with primary ovarian insufficiency.
Morgan Ortiz F, Meza Mendoza C, Beltran Lugo I, Caballero Rodriguez B, Contreras Soto JO. Resistant ovary syndrome. Case report. Ginecol Obstet Mex. 2011;79:436-40. PubMed PMID: 21966839.
Shangold MM, Turksoy RN, Bashford RA, Hammond CB. Pregnancy following the “insensitive ovary syndrome”. Fertil Steril. 1977;28:1179-81. doi: 10.1016/s0015-0282(16)42914-6. PubMed PMID: 923834.
Fleming R, Seifer DB, Frattarelli JL, Ruman J. Assessing ovarian response: antral follicle count versus anti-Mullerian hormone. Reprod Biomed Online. 2015;31:486-96. doi: 10.1016/j.rbmo.2015.06.015. PubMed PMID: 26283017.
Andersen CY, Schmidt KT, Kristensen SG, Rosendahl M, Byskov AG, Ernst E. Concentrations of AMH and inhibin-B in relation to follicular diameter in normal human small antral follicles. Hum Reprod. 2010;25:1282-7. doi: 10.1093/humrep/deq019. PubMed PMID: 20228388.
Hansen KR, Hodnett GM, Knowlton N, Craig LB. Correlation of ovarian reserve tests with histologically determined primordial follicle number. Fertil Steril. 2011;95:170-5. doi: 10.1016/j.fertnstert.2010.04.006. PubMed PMID: 20522327.
Li Y, Pan P, Yuan P, Qiu Q, Yang D. Successful live birth in a woman with resistant ovary syndrome following in vitro maturation of oocytes. J Ovarian Res. 2016;9:54. doi: 10.1186/s13048-016-0263-6. PubMed PMID: 27599836; PubMed Central PMCID: PMCPMC5012097.
Van Campenhout J, Vauclair R, Maraghi K. Gonadotropin--resistant ovaries in primary amenorrhea. Obstet Gynecol. 1972;40:6-12. doi: 10.1097/00006250-197207000-00002.PubMed PMID: 5044939.
Jones GS, De Moraes-Ruehsen M. A new syndrome of amenorrhae in association with hypergonadotropism and apparently normal ovarian follicular apparatus. Am J Obstet Gynecol. 1969;104:597-600. doi: 10.1016/s0002-9378(16)34255-7. PubMed PMID: 5786709.
Galvao A, Segers I, Smitz J, Tournaye H, De Vos M. In vitro maturation (IVM) of oocytes in patients with resistant ovary syndrome and in patients with repeated deficient oocyte maturation. J Assist Reprod Genet. 2018;35:2161-71. doi: 10.1007/s10815-018-1317-z. PubMed PMID: 30238176; PubMed Central PMCID: PMCPMC6289928.
Flageole C, Toufaily C, Bernard DJ, Ates S, Blais V, Chenier S, et al. Successful in vitro maturation of oocytes in a woman with gonadotropin-resistant ovary syndrome associated with a novel combination of FSH receptor gene variants: a case report. J Assist Reprod Genet. 2019;36:425-32. doi: 10.1007/s10815-018-1394-z. PubMed PMID: 30610662; PubMed Central PMCID: PMCPMC6439039.
