Fertility journey of a patient with McCune-Albright syndrome associated with bilateral ovarian involvement

Abstract

Objective: To report a patient with McCune-Albright syndrome (MAS) with bilateral ovarian involvement who had achieved a pregnancy through in vitro fertilization (IVF). Design: Case report. Setting: Academic fertility center. Patient(s): A 33-year-old female with McCune-Albright syndrome who presented with primary infertility because of ovulatory dysfunction secondary to excessive secretion of growth hormone in addition to autonomous estrogen secretion by her ovaries. Exposure: In vitro fertilization and near-normalization of insulin-like growth factor-1 (IGF-1) using somatostatin analogue lanreotide. Main Outcome Measure(s): Reproductive outcomes after medical treatment for MAS-associated anovulatory infertility involving bilateral MAS ovarian involvement and growth hormone excess. Result(s): Spontaneous ovulation was resumed in this patient using lanreotide which regulated IGF-1 levels after unsuccessful ovulation induction with letrozole. Despite documented ovulation, she failed to conceive and subsequently, underwent an IVF cycle using an antagonist cycle with recombinant follicular stimulating hormone and recombinant luteinizing hormone stimulation. A total of 13 oocytes were retrieved and three good quality blastocysts were cryopreserved. Two frozen embryo transfer cycles were completed and she achieved a pregnancy, which unfortunately ended in an incomplete miscarriage. Conclusion(s): Through IVF and near-normalization of IGF-1 using lanreotide, pregnancy was achieved in a patient with MAS who had achieved good ovarian stimulation despite a history of bilateral ovarian involvement and associated hyperfunctioning endocrinopathies.

Keywords

• McCune-Albright syndrome
• recurrent ovarian cysts
• in vitro fertilization (IVF)