Allergic reaction to a highly purified urinary follicle stimulating hormone preparation in controlled ovarian hyperstimulation for in vitro fertilization

We report a case of general hypersensitivity-like allergic reactions to int ramuscular injections of highly purified urinary follicle stimulating hormo ne (uFSH-HP) successfully managed by using intramuscular recombinant FSH (r FSH). The patient underwent a first cycle of in vitro fertilization (IVF) and con trolled ovarian hyperstimulation (COH) was achieved with a combination of g onadotropin releasing hormone against (GnRH-a) and uFSH-HP. Because, after oocyte recovery, no fertilization occurred, the couple subsequently entered an intracytoplasmic sperm injection (ICSI) program. During the COH, the wo man developed general hypersensitivity-like allergic reactions with itching , redness and swelling. Although there was regular follicular growth, the a llergic symptoms worsened and, on day 8 of COH, the stimulation cycle was s uspended. A few months later, the patient entered a new ICSI cycle. COH was achieved by using a combination of GnRH-a and rFSH. The cycle was complete d and the patient did not report any allergic reaction. To avoid allergic reaction to the protein components of the urine-derived F SH preparations, the use of rFSH is suggested in those patients who present local and/or general hypersensitivity-like allergic reactions.