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Fig. 1 | BMC Pregnancy and Childbirth

Fig. 1

From: Successful pregnancy and live birth from a hypogonadotropic hypogonadism woman with low serum estradiol concentrations despite numerous oocyte maturations: a case report

Fig. 1

Follicular development following controlled ovarian stimulation (COS). Ovarian response was monitored through the use of transvaginal ultrasonography during COS. During the first COS, measurable follicles were not observed in either ovary on day 3 of the menstrual cycle (MC). On the same day, COS was initiated with daily administration of 225 international unit (IU) recombinant follicle stimulating hormone (rFSH). Follicular development and increased progesterone (P4) concentrations were observed, but estradiol (E2) concentrations were low on day 11. Although the right (R) and left (L) ovaries had over 30 follicles of 15–19 mm on day 13, serum E2 concentrations were low at 484 pg/ml and P4 concentrations were high at 2.09 ng/ml. COS was canceled due to the hormone concentration which did not reflect those of numerous follicular developments. From the day when the first COS was canceled, the patient took 10 mg synthetic progesterone (SP) orally for the next 14 days. The patient experienced withdrawal bleeding, and several small follicles were observed in both ovaries on day 3. From the same day, the daily dosage of 175 IU rFSH was administered for the first 5 days, followed by 200 IU for the remaining treatment period. Similar to the response seen at the first COS, high serum P4 concentrations, 2.11 ng/ml, were observed; however, serum E2 concentrations, 701 pg/ml, did not reflect those of numerous follicular developments

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