August 9th, 2022

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Successful Pregnancy and Live Birth from Oocytes Retrieved After 50 Hours of Human Chorionic Gonadotropin Injection: A Case Report
Authors:  Munawar Hussain, F.C.P.S., M.R.C.O.G., M.Sc., Valentine Akande, M.R.C.O.G, Ph.D., and Uma Gordon, M.D, F.R.C.O.G.
BACKGROUND: The timing of human chorionic gonadotropin (hCG) injection and oocyte retrieval in women undergoing in vitro fertilization and intracytoplasmic sperm injection is crucial. If not properly timed, premature spontaneous luteinizing hormone surge or even premature ovulation may lead to cancellation of the treatment cycle. Commonly, oocyte retrieval is planned 3236 hours after hCG injection. This time interval is of relevance because a number of essential processes, including the start of luteinization and resumption of the reduction division of the oocytes, should be well established before oocyte retrieval.

CASE: We present a rare case in which, due to patient misunderstanding of timing of hCG injection, oocytes were retrieved 50 hours after hCG injection. On the morning of the oocyte retrieval at 08.00 hours it became apparent that, by mistake, the patient had taken the hCG injection at 09.15 hours rather than at 21.15 hours, 12 hours earlier than advised. It was therefore already 48 hours post-hCG injection. Nineteen good-quality, mature oocytes were retrieved, resulting in 11 good-quality embryos. A single expanded blastocyst was transferred, resulting in pregnancy and delivery of a healthy female infant.

CONCLUSION: This is the first reported case of successful pregnancy after oocyte retrieval 5o hours after hCG injection. This case could be a stimulus for others to conduct further studies of prolonged exposure of hCG to oocyte retrieval to show the improved outcome of assisted reproduction treatment.
Keywords:  assisted reproductive techniques, controlled ovarian stimulation, HCG, human chorionic gonadotropin, ICSI, in vitro fertilization, intracytoplasmic sperm injection, live birth, oocyte retrieval, pregnancy
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