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已发表论文
多囊卵巢综合征患者基础黄体生成素升高且反复促排卵失败后成功妊娠 1 例报告
Authors Fang Y , Zhao X, Wang C , Liu C , Liang Y, Yang X
Received 3 June 2025
Accepted for publication 29 August 2025
Published 22 September 2025 Volume 2025:17 Pages 3145—3154
DOI https://doi.org/10.2147/IJWH.S542581
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Dr Everett Magann
Ying Fang, Xuehan Zhao, Cong Wang, Chang Liu, Yu Liang,* Xiaokui Yang*
Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaokui Yang; Yu Liang, Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, People’s Republic of China, Tel +86-10-85985110, Email yangxiaokui@ccmu.edu.cn; liangyu1981830@163.com
Abstract: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology, leading to infertility. Elevated basal luteinizing hormone (bLH) levels in PCOS can impede the efficacy of ovulation induction (OI). This case report explores the management of a 26-year-old woman with PCOS and high bLH levels who experienced repeated failure in OI attempts. During in vitro fertilization-embryo transfer (IVF-ET) treatments, she underwent two cycles of controlled ovarian stimulation using long-acting gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols respectively, both of which failed due to inadequate ovarian response despite normal bLH levels on the day of gonadotropin initiation. In the third cycle, a progestin-primed ovarian stimulation (PPOS) protocol combined with letrozole was adopted without bLH pretreatment, resulting in a successful pregnancy and healthy child after frozen-thawed embryo transfer. This case highlights the need for tailored approaches in managing PCOS patients with high bLH levels and indicates that elevated bLH may not always impair IVF outcomes. Further research is needed to establish the optimal bLH threshold and management protocols to enhance reproductive outcomes for these patients.
Plain Language Summary: In this case report, we share the story of a young woman with polycystic ovary syndrome (PCOS) and high basal luteinizing hormone (bLH) who was struggling with primary infertility. She has experienced multiple failed attempts on ovulation induction. During two consecutive IVF treatments, she encountered cycle cancellation due to inadequate ovarian response despite normalizing basal LH levels. In the third cycle, a progestin-primed ovarian stimulation protocol combined with letrozole was used without pretreating elevated bLH. The patient responded well to this approach and achieved a successful pregnancy, eventually giving birth to a healthy child. This case sheds light on the management of PCOS patients with high bLH levels and repeated treatment failures. It indicates that high bLH does not always compromise IVF success and inspires hope for those facing comparable challenges.
Keywords: polycystic ovary syndrome, basal luteinizing hormone, controlled ovarian stimulation, in vitro fertilization-embryo transfer
Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaokui Yang; Yu Liang, Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, People’s Republic of China, Tel +86-10-85985110, Email yangxiaokui@ccmu.edu.cn; liangyu1981830@163.com
Abstract: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology, leading to infertility. Elevated basal luteinizing hormone (bLH) levels in PCOS can impede the efficacy of ovulation induction (OI). This case report explores the management of a 26-year-old woman with PCOS and high bLH levels who experienced repeated failure in OI attempts. During in vitro fertilization-embryo transfer (IVF-ET) treatments, she underwent two cycles of controlled ovarian stimulation using long-acting gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols respectively, both of which failed due to inadequate ovarian response despite normal bLH levels on the day of gonadotropin initiation. In the third cycle, a progestin-primed ovarian stimulation (PPOS) protocol combined with letrozole was adopted without bLH pretreatment, resulting in a successful pregnancy and healthy child after frozen-thawed embryo transfer. This case highlights the need for tailored approaches in managing PCOS patients with high bLH levels and indicates that elevated bLH may not always impair IVF outcomes. Further research is needed to establish the optimal bLH threshold and management protocols to enhance reproductive outcomes for these patients.
Plain Language Summary: In this case report, we share the story of a young woman with polycystic ovary syndrome (PCOS) and high basal luteinizing hormone (bLH) who was struggling with primary infertility. She has experienced multiple failed attempts on ovulation induction. During two consecutive IVF treatments, she encountered cycle cancellation due to inadequate ovarian response despite normalizing basal LH levels. In the third cycle, a progestin-primed ovarian stimulation protocol combined with letrozole was used without pretreating elevated bLH. The patient responded well to this approach and achieved a successful pregnancy, eventually giving birth to a healthy child. This case sheds light on the management of PCOS patients with high bLH levels and repeated treatment failures. It indicates that high bLH does not always compromise IVF success and inspires hope for those facing comparable challenges.
Keywords: polycystic ovary syndrome, basal luteinizing hormone, controlled ovarian stimulation, in vitro fertilization-embryo transfer