In vitro fertilization surrogacy in rare coexisting Mayer-Rokitansky-Kuster-Hauser syndrome and triple X karyotype

Objective To report the responses to IVF surrogacy attempts in a female with a heretofore never described combination of Mayer-Rokitansky-Kuster-Hauser (MRHK) syndrome and triple X karyotype. Design Case report. Setting Reproductive unit of a university-affiliated medical center. Patient(s) A 29-year-old female diagnosed as having both MRHK syndrome and a triple X (47XXX) karyotype. Intervention(s) Five cycles of IVF surrogacy. Main Outcome Measure(s) Recovery of oocytes after controlled ovarian stimulation. Result(s) A maximum of five oocytes were retrieved by percutaneous abdominal aspiration of a single subcostal left ovary. After five unsuccessful IVF trials due to low ovarian response attributed to her coexisting MRHK syndrome and triple X karyotype, the patient's choice was oocyte donation. Conclusion(s) An abnormal karyotype can coexist with MRKH syndrome, albeit very rarely, and probably accounts for a low ovarian response to attempts to achieve IVF surrogacy.