Mature oocyte retrieval without an exogenous trigger during random-start stimulation in a very early intrauterine pregnancy: a case report

IF 2.2

FS Reports Pub Date : 2026-08-01 Epub Date: 2026-04-10 DOI:10.1016/j.xfre.2026.04.003

Mohammad Saaed ElFarran M.D., M.Sc., Karolina Palinska-Rudzka M.D., M.R.C.O.G., Raj Mathur M.D., F.R.C.O.G.

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Abstract

Objective

To describe a rare case of mature oocyte retrieval without an exogenous trigger during random-start controlled ovarian stimulation (RS-COS) coinciding with a very early intrauterine pregnancy.

Design

Case report.

Subject

A 32-year-old para 1 patient with inflammatory breast cancer (grade 3, T4N2M0, ER/PR negative, HER2 3+, Ki-67 60%).

Exposure

Luteal-phase RS-COS using a gonadotropin-releasing hormone antagonist protocol with human menopausal gonadotropin (hMG) 300 IU daily. Egg retrieval was performed on day 12 after stimulation.

Main Outcome Measures

Number and maturity of oocytes retrieved; occurrence of ovarian hyperstimulation syndrome (OHSS).

Results

On day 10 of stimulation, 25 follicles measuring ≥12 mm were seen, of which 18 were in the right ovary. A gestational sac was seen in the uterine cavity. The serum human chorionic gonadotropin level was 2,563 IU/L. Oocyte retrieval from the right ovary was performed without administering a trigger. Nine metaphase II oocytes were retrieved and vitrified; mild clinical OHSS occurred.

Conclusion

This case demonstrates that it may be possible to perform COS in early pregnancy and be able to retrieve mature oocytes without the use of an exogenous trigger. To our knowledge, there are no previous published reports of multiple metaphase II oocyte retrieval without an exogenous trigger during RS-COS.

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在非常早期的宫内妊娠随机启动刺激过程中，成熟卵母细胞在没有外源触发的情况下恢复：一例报告

目的描述一例罕见的无外源触发的随机启动控制卵巢刺激（RS-COS）中成熟卵母细胞的回收，并与早期宫内妊娠相吻合。DesignCase报告。研究对象：32岁炎性乳腺癌1期患者（3级，T4N2M0， ER/PR阴性，her2.3 +, Ki-67 60%）。暴露于黄体期RS-COS，使用促性腺激素释放激素拮抗剂方案，人绝经期促性腺激素（hMG）每日300 IU。刺激后第12天取卵。主要观察指标：卵母细胞数量和成熟度；卵巢过度刺激综合征（OHSS）的发生。结果刺激第10天，观察到≥12 mm卵泡25个，其中右侧卵巢18个。子宫腔内可见妊娠囊。血清人绒毛膜促性腺激素水平为2563 IU/L。在没有触发的情况下从右卵巢取出卵母细胞。取出9个中期II期卵母细胞并玻璃化；出现轻度临床OHSS。结论本病例表明，在妊娠早期进行COS并能够在不使用外源触发的情况下恢复成熟卵母细胞是可能的。据我们所知，在RS-COS期间没有外源触发的多个中期II卵母细胞回收的先前未发表的报道。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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