Live birth of dichorious triamniotic triple after ovulation stimulation by aromatase inhibitors in polycystic ovarian syndrome: A clinical case
DOI:
https://doi.org/10.37800/RM.2.2022.63-69Keywords:
anovulatory infertility, ovulation stimulation, polycystic ovary syndrome (PCOS), aromatase inhibitors, multiple pregnancyAbstract
Relevance: Polycystic ovary syndrome is the most common hormonal disease in women and is noted in approximately 80% of women with anovulatory infertility. Today, aromatase inhibitors are used as first-line therapy in women with anovulatory infertility who lack other infertility factors.
The purpose was to present a clinical case of live birth of dichoral triamniotic triplets after ovulation stimulation with aromatase inhibitors in polycystic ovary syndrome.
Methods: The article describes the clinical case of live birth of dichorial triamniotic triplets after stimulation with aromatase
inhibitors in polycystic ovary syndrome in a patient with primary infertility associated with lack of ovulation.
Results: By publication, the triplets born with a favorable outcome, and the mother, were discharged from the maternity
hospital.
Conclusion: The active use of such drugs as antiestrogens and aromatase inhibitors to stimulate ovulation in the practice
of reproductologists has helped many patients with anovulatory infertility become pregnant. At the same time, the risks of
multiple pregnancies also increase due to the drug-induced maturation of two and more follicles. Patients should be warned and
be prepared mentally and physically both for carrying a multiple pregnancy and for the fact of embryo reduction.
Such pregnancy requires successive and joint attention of a fertility specialist and obstetricians at the PHC level and neonatologists while further nursing the children.
References
Bozdag G., Mumusoglu S., Zengin D., Karabulut E., Yildiz B.O. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis // Hum. Reprod. – 2016. – Vol. 31. – P. 2841-2855. https://doi.org/10.1093/humrep/dew218.
March W.A., Moore V.M., Willson K.J., Phillips D.I.W., Norman R.J., Davies M.J. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria // Hum. Reprod.. – 2010. – Vol. 25(2). – P. 544–551. https://doi.org/10.1093/humrep/dep399.
Yildiz B.O., Bozdag G., Yapici Z., Esinler I., Yarali H. Prevalence, phenotype and cardio metabolic risk of polycystic ovary syndrome under different diagnostic criteria // Hum. Reprod. – 2012. – Vol. 27(10). P. 3067–3073. https://doi.org/10.1093/humrep/des232.
Berger J.J., Bates G.W. Optimal management of subfertility in polycystic ovary syndrome // Int. J. Women’s Health. – 2014. – Vol. 6. – P. 613–621. https://doi.org/10.2147/IJWH.S48527.
Панарина О.В., Рашидова М.А., Беленькая Л.В., Трофимова Т.А. Шолохов Л.Ф. Современные представления о синдроме поликистозных яичников // Acta Biomedica Scientifica – 2017. – № 4(2). – С. 9-14. [Panarina O.V., Rashidova M.A., Belen’kaya L.V., Trofimova T.A. Sholoxov L.F. Sovremennye predstavleniya o syndrome polikistoznyx yaichnikov // Acta Biomedica Scientifica – 2017. – №4(2). – S. 9-14. (in Russ.)]. https://doi.org/10.12737/article_59fad50f053c20.99807656.
Назаренко Т.А., Здановский В.М. Синдром поликистозных яичников (современные подходы к диагностике и лечению бесплодия). – М.: Медпресс-информ. – 2005. – 207 с. [Nazarenko T.A., Zdanovskij V.M. Sindrom polikistoznyx yaichnikov (sovremennye podxody k diagnostike i lecheniyu besplodiya). – М.: Medpress-inform. – 2005. – 207 s. (in Russ.)]. https://moniiag.ru/wp-content/uploads/2019/07/Sindrom-polikistoznyh-yaichnikov.pdf
Sadeghi H.M., Adeli I., Calina D., Docea A.O., Mousavi T., Daniali M., Nikfar S., Tsatsakis A., Abdollahi M. Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing // Int. J. Mol. Sci. 2022. – Vol. 23(2). – Art. ID 583. https://doi.org/10.3390/ijms23020583.
Goodman N.F., Cobin R.H., Futterweit W., Glueck J.S., Legro R.S., Carmina E., American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society. Disease State Clinical Review. Guide to the best practices in the evaluation and treatment of polycystic ovary syndrome – part 2 // Endocr Pract. – 2015. – Vol. 21(12). – P. 1415-1426. https://doi.org/10.4158/EP15748.DSCPT2.
Azziz R. Polycystic Ovary Syndrome // Obstet. Gynecol. – 2018. – Vol. 132(2). – P. 321-336. https://doi.org/10.1097/AOG.0000000000002698.
Dickey R.P., Sartor B.M. Clomiphene Stair-Step Protocol for Women with Polycystic Ovary Syndrome // Obstet. Gynecol. – 2018. – Vol. 131(6). – P. 1165. https://doi.org/10.1097/AOG.0000000000002669.
Legro R.S., Bryski R.G., Diamond M.P., Coutifaris C., Schlaff W.D., Casson P., Christman G.M., Huang H., Yan Q., Akvero R., Haisenleder D.J., Barnhart K.T., Bates G.W., Usadi R., Lucidi S., Baker V., Trussel J.C., Krawetz S.A., Snyder P., Ohl D., Santoro N., Eisenberg E., Zhang H. for the NICHD Reproductive Medicine Network. Letrozole versus Clomiphene for infertility in the polycystic ovary syndrome // N. Engl. J. Med. – 2014. – Vol. 371(2). – P. 119-129. https://doi.org/10.1056/NEJMoa1313517.
Franik S., Kremer J.A.M., Nelen W.L.D.M., Farquhar C., Majoribanks J. Aromatase inhibitors for subfertile women with polycystic ovary syndrome: summary of a Cochrane review // Fertil. Steril. – 2014. – Vol. 103(2). – P. 353-355. https://doi.org/10.1016/j.fertnstert.2014.10.016.
Николаенков И.П., Кузьминых Т.У., Тарасова М.А., Серегина Д.С. Особенности течения беременности у пациенток с синдромом поликистозных яичников // Журнал акушерства и женских болезней. – 2020. – №5(69). – C. 105-112. [Nikolaenkov I.P., Kuz’minyx T.U., Tarasova M.A., Seregina D.S. Osobennosti techeniya beremennosti u pacientok s sindromom polikistoznyx yaichnikov // Zhurnal akusherstva I zhenskix boleznej. – 2020. – № 5(69). – S. 105-112 (in Russ.)]. https://doi.org/10.17816/JOWD695105-112.
Jahan R., Jahan K., Afrose R., Akhter S., Fatema S., Dey S., Khan M.M. Obstetric Outcome of Multiple Pregnancy in a Medical College Hospital // Mymensingh Med J. –2021. – Vol. 30(3). – P. 633-637. https://pubmed.ncbi.nlm.nih.gov/34226448/.
Yokoyama Y., Shimizu T., Hayakawa K. [Antenatal complications in triplet pregnancies and birth weights of triplets compared with those of twins (in Japanese)] // Nihon Koshu Eisei Zasshi. – 2015. – Vol. 42(2). – P. 113-120. https://pubmed.ncbi.nlm.nih.gov/7718906/.
Keith L.G., Oleszczuk J.J. Triplet births in the United States. An epidemic of high-risk pregnancies // J. Reprod. Med. – 2012. – Vol. 47(4). – P. 259-265. https://pubmed.ncbi.nlm.nih.gov/12012876/.
Краснопольский В.И., Новикова С.В., Цивцивадзе Е.Б., Жарова А.А. Ведение беременности и родов при многоплодной беременности // Альманах клин. мед. – 2015. – №37. – С. 32-40 [Krasnopol’skij V.I., Novikova S.V., Civcivadze E.B., Zharova A.A. Vedenie beremennosti i rodov pri mnogoplodnoj beremennosti // Al’manax klin. med. - 2015. – №37. – S. 32-40. (in Russ.)]. https://elibrary.ru/download/elibrary_23283534_43599984.pdf.
Downloads
Published
How to Cite
Issue
Section
License
The articles published in this Journal are licensed under the CC BY-NC-ND 4.0 (Creative Commons Attribution – Non-Commercial – No Derivatives 4.0 International) license, which provides for their non-commercial use only. Under this license, users have the right to copy and distribute the material in copyright but are not permitted to modify or use it for commercial purposes. Full details on the licensing are available at https://creativecommons.org/licenses/by-nc-nd/4.0/.
