The progestin anchor: salvaging mature oocyte yield after an unplanned six-day gonadotropin pause in oncofertility-a case report.
- 1Bocian Fertility Clinic, Gynecology and Obstetrics, Szczecin, Poland.
- 2Bocian Fertility Clinic, Gynecology and Obstetrics, Gdańsk, Poland.
- 3Bocian Fertility Clinic, Gynecology and Obstetrics, Białystok, Poland.
Abstract
Objective
To describe the retrieval of mature oocytes after an unplanned 6-day gonadotropin-free interval during oncofertility ovarian stimulation.Design
Case report.Subjects
A 22-year-old active-duty soldier with a serous borderline ovarian tumor undergoing fertility preservation after ovarian surgery.Exposure
Progestin-primed ovarian stimulation using follitropin alfa and medroxyprogesterone acetate as the sole luteinizing hormone suppressor. Gonadotropin administration was unexpectedly interrupted for 6 days because of a nondeferrable military summons, while oral medroxyprogesterone acetate was maintained.Main outcome measures
Metaphase II (MII) oocyte yield and maturation rate.Results
The patient had undergone ovarian surgery approximately 9 months before the reference cycle and 12 months before the index cycle. Baseline antimüllerian hormone before fertility preservation was 1.77 ng/mL. In the reference cycle, 13 follicles ≥14 mm were present on the trigger day, and 13 oocytes were retrieved, including six MII oocytes that were vitrified. At the ultrasound assessment immediately preceding the gonadotropin-free interval in the index cycle, ultrasound showed nine visible follicles, including three follicles measuring <14 mm and six follicles measuring ≥14 mm. After the 6-day interval, the trigger-day ultrasound showed seven follicles ≥14 mm in diameter, ranging from 17 to 19 mm. Estradiol remained nearly stable across the interval, from 1,612 to 1,580 pg/mL, and endogenous progesterone on the trigger day was 1.1 ng/mL. Seven oocytes were retrieved, including five MII oocytes that were vitrified.Conclusion
In this selected oncofertility patient undergoing progestin-primed ovarian stimulation, an unplanned 6-day gonadotropin-free interval did not preclude retrieval of a clinically meaningful number of mature oocytes. Continuous medroxyprogesterone acetate may represent a biologically plausible protective factor against premature luteinization, although causality cannot be inferred from a single case.
Related
- Patient-Reported Tolerability, Treatment Initiation, and Discontinuation of Postoperative Progestin Therapy After Cesarean Scar Repair in Women Planning Pregnancy
- Precision Oncofertility: Integrating Genomics, Reproductive Biomarkers, Treatment Toxicity Profiles, and Foundation Models for Fertility Preservation in Men and Women with Cancer
- Salvaging the forgotten valve: T-TEER as the new frontier in torrential primary TR
- The minipig as a programmable translational platform for experimental oncofertility
- Comparative Analysis of Progestin Intervention for Non-Atypical Endometrial Hyperplasia in Infertile Females with Anovulation: A Retrospective Study.
BibTeX
@article{ciepiela2026progestin,
title = {{The progestin anchor: salvaging mature oocyte yield after an unplanned six-day gonadotropin pause in oncofertility-a case report.}},
author = {Przemysław Ciepiela and Arkadiusz Adamczyk and Joanna Aszkiełowicz and Weronika Józefowska and Grzegorz Mrugacz},
journal = {F\&S reports},
year = {2026},
month = jul,
doi = {10.1016/j.xfre.2026.07.001},
url = {https://europepmc.org/article/MED/42903388},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The progestin anchor: salvaging mature oocyte yield after an unplanned six-day gonadotropin pause in oncofertility-a case report.
AU - Przemysław Ciepiela
AU - Arkadiusz Adamczyk
AU - Joanna Aszkiełowicz
AU - Weronika Józefowska
AU - Grzegorz Mrugacz
PY - 2026
DA - 2026/07/09
JO - F&S reports
DO - 10.1016/j.xfre.2026.07.001
UR - https://europepmc.org/article/MED/42903388
AB - Objective To describe the retrieval of mature oocytes after an unplanned 6-day gonadotropin-free interval during oncofertility ovarian stimulation.Design Case report.Subjects A 22-year-old active-duty soldier with a serous borderline ovarian tumor undergoing fertility preservation after ovarian surgery.Exposure Progestin-primed ovarian stimulation using follitropin alfa and medroxyprogesterone acetate as the sole luteinizing hormone suppressor. Gonadotropin administration was unexpectedly interrupted for 6 days because of a nondeferrable military summons, while oral medroxyprogesterone acetate was maintained.Main outcome measures Metaphase II (MII) oocyte yield and maturation rate.Results The patient had undergone ovarian surgery approximately 9 months before the reference cycle and 12 months before the index cycle. Baseline antimüllerian hormone before fertility preservation was 1.77 ng/mL. In the reference cycle, 13 follicles ≥14 mm were present on the trigger day, and 13 oocytes were retrieved, including six MII oocytes that were vitrified. At the ultrasound assessment immediately preceding the gonadotropin-free interval in the index cycle, ultrasound showed nine visible follicles, including three follicles measuring <14 mm and six follicles measuring ≥14 mm. After the 6-day interval, the trigger-day ultrasound showed seven follicles ≥14 mm in diameter, ranging from 17 to 19 mm. Estradiol remained nearly stable across the interval, from 1,612 to 1,580 pg/mL, and endogenous progesterone on the trigger day was 1.1 ng/mL. Seven oocytes were retrieved, including five MII oocytes that were vitrified.Conclusion In this selected oncofertility patient undergoing progestin-primed ovarian stimulation, an unplanned 6-day gonadotropin-free interval did not preclude retrieval of a clinically meaningful number of mature oocytes. Continuous medroxyprogesterone acetate may represent a biologically plausible protective factor against premature luteinization, although causality cannot be inferred from a single case.
SN - 2666-3341
ER -