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Clinical and Experimental Obstetrics & Gynecology  2019, Vol. 46 Issue (4): 635-636    DOI: 10.12891/ceog4709.2019
Case Report Previous articles | Next articles
Injection of human chorionic gonadotropin (hCG) can cause the luteinized unruptured follicle syndrome
J.H. Check1, 2, *(), M.P. Dougherty3
1Cooper Medical School Of Rowan University, Department Of Obstetrics And Gynecology, Division Of Reproductive Endocrinology & Infertility, Camden, NJ, USA
2Cooper Institute For Reproductive And Hormonal Disorders, P.C., Mt. Laurel, NJ, USA
3Rutgers Robert Wood Johnson Medical School, Robert Wood Hohnson Univeristy Hospital, Department Of Obstetrics, Gynecology and Reproductive Sciences New Brunswick, NJ, USA
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Abstract  

Purpose: To demonstrate that the injection of human chorionic gonadotropin (hCG) intramuscularly for purpose of timing of an intrauterine insemination (IUI) can cause an oocyte to fail to rupture from the follicle. Materials and Methods: A 33-year-old woman sought help for infertility that seemed related to a male factor problem. The office performed IUI’s morning and evenings on weekdays but only in the morning on weekends. The timing of IUI was generally 40 to 48 hours after the initiation of the luteinizing hormone (LH) surge. When a follicle reached a minimum E2 of 200 pg/mL and an ultrasound with at least one follicle of an average of 20 mm, an injection of hCG 10,000 units I.M. was given in the evening on a Thursday or Friday, for an IUI on Saturday or Sunday. Weekday IUI’s were based on endogenous LH surge. Ultrasounds were performed on the day of IUI and the next day, if no oocyte was released. Release was considered to have occurred if shrinkage of the follicle by >5 mm took place without the serum P exceeded 2 ng/dL. Results: In six natural cycles where IUI was performed Monday-Friday, the peak sera E2 levels reached 368, 334, 337, 465, 365, and 355 pg/mL. Oocyte release was confirmed in all six cycles. There were two cycles where hCG was given for weekend IUI’s. In neither cycle was oocyte release demonstrated. Leuprolide acetate also failed to cause oocyte release. Discussion: Though hCG injection and GnRH agonists can correct the luteinized unruptured follicle (LUF) syndrome, in some instances, hCG and GnRH agonists can actually cause LUF syndrome.

Key words:  Luteinized unruptured follicle syndrome: Human chorionic gonadotropin injection      Gonadotropin releasing hormone agonist      Natural cycle     
Published:  10 August 2019     
*Corresponding Author(s):  J.H. CHECK     E-mail:  laurie@ccivf.com

Cite this article: 

J.H. Check, M.P. Dougherty. Injection of human chorionic gonadotropin (hCG) can cause the luteinized unruptured follicle syndrome. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(4): 635-636.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog4709.2019     OR     https://ceog.imrpress.com/EN/Y2019/V46/I4/635

[1] Hyo Kyozuka, Shu Soeda, Shinji Nomura, Manabu Kojima, Takafumi Watanabe, Keiya Fujimori. Polypoid endometriosis in a young woman: a case report and review of literature[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(2): 323-326.
[2] J.H. Check. A second case of successful conception in a natural cycle despite a maximum endometrial thickness in the follicular phase of four mm[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(3): 341-342.
[3] J. H. Check, J. Vaniver, D. Senft, G. DiAntonio, D. Summers. The use of granulocyte colony stimulating factor to enhance oocyte release in women with the luteinized unruptured follicle syndrome[J]. Clinical and Experimental Obstetrics & Gynecology, 2016, 43(2): 178-180.
[4] J.H. Check, C. Wilson, R. Cohen, J.K. Choe, D. Corley. Mid-luteal phase injection of subcutaneous leuprolide acetate improves live delivered pregnancy and implantation rates in younger women undergoing in vitro fertilization-embryo transfer (IVF-ET)[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(4): 427-428.
[5] J.H. Check, J. Liss, R. Cohen. A comparison of three types of therapies for three different ovulation disorders in establishing pregnancies and evaluation of laboratory parameters that could influence the outcome[J]. Clinical and Experimental Obstetrics & Gynecology, 2013, 40(3): 317-318.
[6] J.H. Check. Mild increases in serum FSH in late follicular phase increases the risk of the luteinized unruptured follice: case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2013, 40(3): 433-434.
[7] J.H. Check, J. Liss. The effect of diminished oocyte reserve in younger women (age ≤ 37) on pregnancy rates in natural cycles[J]. Clinical and Experimental Obstetrics & Gynecology, 2013, 40(1): 27-28.
[8] J.H. Check. Luteal phase support for in vitro fertilization-embryo transfer – present and future methods to improve successful implantation[J]. Clinical and Experimental Obstetrics & Gynecology, 2012, 39(4): 422-428.
[9] I. Korkontzelos, N. Antoniou, Th. Stefos, I. Kyparos, S. Lykoudis. Ruptured heterotopic pregnancy with successful obstetrical outcome: A case report and review of the literature[J]. Clinical and Experimental Obstetrics & Gynecology, 2005, 32(3): 203-206.
[10] A. Gocmen, I. Hamdi Kara, M. Karaca. The effects of add-back therapy with tibolone on myoma uteri[J]. Clinical and Experimental Obstetrics & Gynecology, 2002, 29(3): 219-221.
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