Impaired corpus luteum function and other undesired results of pregnancies associated with inadvertent administration of a long-acting agonist of gonadotrophin-releasing hormone

Spontaneous pregnancies associated with inadvertent periconceptional administration of long-acting gonadotrophin releasing-hormone agonist (GnRHa), in in-vitro fertilization, occurred in 11 of 161 patients with non-tubal infertility. All these cases exhibited impaired function of the corpus luteum in terms of declining progesterone levels, despite rising levels of human chorionic gonadotrophin. The patients were categorized according to the timing of GnRHa administration: periovulatory (three cases), midluteal (five cases) and late luteal (three cases). Altogether, of the 11 pregnancies, seven ended with a normal livebirth, three with a preclinical gestation and one with a blighted ovum. It appears that spontaneous pregnancies associated with inadvertent administration of GnRHa are not rare. Awareness for early diagnosis and close hormonal monitoring are recommended for the assessment of corpus luteum function and adequate supplementation.