Inadvertent recombinant human follicle stimulating hormone bolus instead of human chorionic gonadotrophin leads to the retrieval of competent oocytes in IVF program

Abstract

Objective: To present a case where recombinant human FSH (r-hFSH) was accidentally used instead of hCG and resulted in oocyte maturation.

Design: Case report.

Setting: A tertiary infertility center.

Patient(s): A 36-year-old woman underwent IVF for infertility problems. The couple was unable to obtain a pregnancy during the previous 2 years.

Intervention(s): Oocyte retrieval after a r-hFSH bolus (two vials of Gonal-F 1050 IU) instead of the routinely used hCG.

Main outcome measure(s): Oocyte maturity evaluation, fertilization after intracytoplasmic sperm injection, cleavage stage, and embryo quality.

Result(s): A total of nine oocytes were retrieved; eight were metaphase II. Three eggs were fertilized by intracytoplasmic sperm injection, and four of the remaining MII oocytes were cryopreserved. All three oocytes fertilized and developed to three good-quality embryos that were transferred on day 2. No pregnancy was obtained from this fresh transfer cycle or from transferred embryos resulting from the thawing cycle.

Conclusion(s): A massive r-hFSH administration can lead to the retrieval of mature MII oocytes that are able to fertilize and give good-quality embryos to transfer.