Infertility Management for Resistant Ovary Syndrome: A Review

Hong Yi ¹ Lin Chen ² Jinglei Zhang ³ Yangxing Wen ³ Xi Zheng ⁴ Xiaoyan Chen ^1*

• ¹ Baoan Women's and Children's Hospital, Shenzhen, Guangdong, China
• ² Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
• ³ The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
• ⁴ Southern Medical University, Guangzhou, Guangdong, China

Resistant ovary syndrome is a rare endocrinological disorder characterized by elevated serum gonadotropins and normal ovarian reserves. The leading causes of this condition include FSHR mutations, post-receptor abnormalities and autoimmunological disorders.Due to follicle maturation defect and anovulation, these patients have menstrual disturbance and infertility. Endocrinological disorders would be solved by regular hormone replacement therapy. However, there is no consensus regarding the infertility issues and current treatment remains empirical with controlled ovarian stimulation (COS) and in vitro maturation. Herein, we conducted a review of current literature, which concludes that: 1) Patient with FSHR mutations had very poor COS outcomes;2) FSH and LH levels poorly predict COS outcomes; 3) Both recombinant and urinary gonadotropins may be effective in COS; 4) The dosage of exogenous gonadotropins is not the key to successful COS; 5) in vitro maturation is a feasible option for patients carrying FSHR mutations or unsuccessful COS cycles.