Simplifying ovulation induction for surrogacy in women with Mayer- Rokitansky-Kuster-Hauser syndrome

A simple approach for ovulation induction in women with Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH-S) during in-vitro fertilization(IVF)/freezing/surrogacy cycles was evaluated. Weekly progesterone plasmaconcentrations were measured in order to accurately establish the lutealphase in MRKH-S women. When a rising titre was detected, agonadotrophin-releasing hormone analogue (GnRHa) was administered as partof a long protocol. Two weeks later human menopausal gonadotrophin (HMG)therapy was started. Ten treatment cycles in four women with MRKH-S werecarried out. In all cases, three or less progesterone estimations wereneeded. Three of the four women are now, through surrogacy, geneticmothers; one of them has two children. We concluded that weeklydetermination of progesterone plasma concentration is a convenient,efficient and inexpensive simple approach to identify the luteal phase, andtherefore suitable to the start of a GnRHa/HMG protocol in MRKH-S womenenrolled in an assisted reproduction technology programme.