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Ovarian Function in an Adult Woman with McCune-Albright Syndrome

Rambam Medical Center. The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, 31096 Israel

Address correspondence to: Zeev Blumenfeld, M.D., Rambam Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, P.O. Box 9602, Haifa, 31096 Israel. E-mail: . bzeev{at}techunix.technion.ac.il

To the editor:

I have read with interest the Clinical Case Seminar "Dynamics of ovarian function in an adult woman with McCune-Albright syndrome," by Laven et al. (1). The authors are to be congratulated for their elegant and scholarly evaluation of their patient and the description and evaluation of this case report.

However, their final conclusion and recommendation may need some elaboration, because the modern assisted reproductive technology may offer these patients another possible option. The authors conclude that the gynecological implications of the McCune-Albright patients may include cycle disturbances and "untreatable infertility" (1). The authors suggest that "extended suppression of endogenous FSH or unilateral ovariectomy should be considered when pregnancy is desired" (1). However, there is a possible alternative to achieve pregnancy using modern assisted reproductive technology. Due to the formation of multiple antral preovulatory follicles, follicular aspiration for egg retrieval may be accomplished, followed by a few days of in vitro maturation and subsequent in vitro fertilization or intracytoplasmatic sperm injection micromanipulation. This approach has been shown to generate clinical gestations in Polycystic Ovary Syndrome patients, avoiding the risk of ovarian hyperstimulation syndrome, in patients with multiple preovulatory follicles (1, 2, 3).

Received October 23, 2001.

References

1. Laven JSE, Lumbroso S, Sultan C, Fauser BCJM 2000 Dynamics of ovarian function in an adult woman with McCune-Albright syndrome. J Clin Endocrinol Metab 86:2625–2630[Free Full Text]
2. Chian RC, Buckett WM, Tulandi T, Tan SL 2000 Prospective randomized study of human chorionic gonadotro priming before immature oocyte retrieval from unstimulated women with polycystic ovarian syndrome. Hum Reprod 15:165–170[Abstract/Free Full Text]
3. Christin-Maitre S, Rongeres-Bertrand C, Kottler ML, Lahlou N, Frydman R, Touraine P, Bouchard P 1998 A spontaneous and severe hyperstimulation of the ovaries revealing a gonadotroph adenoma. J Clin Endocrinol Metab 83:3450–3453[Abstract/Free Full Text]

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