The Activation of Residual Dormant Follicles by Human Chorionic Gonadotropin (HCG) in Vivo: a Novel Treatment for Premature Ovarian Insufficiency

Background: With the influence of factors such as ovarian surgery, high-dose radiotherapy and chemotherapy, environmental degradation, and bad living habits, the occurrence of premature ovarian insufficiency(POI) is getting younger and younger, and many young women's ovaries have entered the aging stage earlier. While many studies have investigated the patients with POI, which is still a challenge in reproductive medicine as the treatments available now are not ideal. POI patients have varying amounts of residual dormant follicles in the ovaries. Therefore, it is critical to further our understanding of primordial follicle activation in order to treat.This study aimed to investigate the activation of residual follicles in POI patients with injection of HCG, whether they could obtain embryos and become pregnant. Methods: Four patients with POI were pretreated with dehydroepiandrosterone, Coenzyme Q10, estrogen and medroxyprogesterone. The prescribed amounts of estrogen and medroxyprogesterone were adjusted to maintain the level of FSH at ˂15 mIU/ml and the level of LH˂10 mIU/ml. When the treatments failed to induce the appearance of follicles after 3 months, the patients received treatment with 10000 IU of HCG. Results: The residual dormant follicles in POI patients can be activated using our approach to obtain embryos and conceive by injection of HCG. Conclusions: POI patients may conceive their own genetic children by activating dormant follicles in vivo . These findings may represent a new simple and feasible solution for the treatment of patients with POI to conceive their own genetic children.