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Background <p>Lymphangioleiomyomatosis is a rare, estrogen-sensitive multisystem disorder that predominantly affects women of reproductive age. Pregnancy and fertility interventions present a unique challenge in patients with lymphangioleiomyomatosis, as an elevated estrogen level during controlled ovarian hyperstimulation and pregnancy may exacerbate the disease.</p> Case presentation <p>We describe a 43-year-old Han Chinese female patient diagnosed with sporadic lymphangioleiomyomatosis because of recurrent pneumothorax and diminished ovarian reserve who had a strong desire for pregnancy. <i>In vitro</i> fertilization was considered the most effective treatment to improve pregnancy rate, with low-estrogen protocols recommended following a comprehensive multidisciplinary evaluation. In the first controlled ovarian hyperstimulation cycle, the patient was treated with a microstimulation protocol, resulting in a peak estradiol level of 621&#xa0;pg/ml. Two fresh embryos were transferred but did not achieve pregnancy. In the second controlled ovarian hyperstimulation cycle, a combination of letrozole and antagonist protocol was used, with a peak estradiol level of 248&#xa0;pg/ml. Endometrial preparation for the frozen embryo transfer was conducted using a natural cycle, leading to a successful pregnancy. Throughout the pregnancy, multidisciplinary collaboration ensured continuous monitoring of both lung function and fetal development. Eventually, she achieved a full-term live birth via elective cesarean section, and pulmonary parameters remained stable after pregnancy.</p> Conclusion <p>This is the first case report presenting a female diagnosed with sporadic lymphangioleiomyomatosis and diminished ovarian reserve who successfully achieved a live birth via <i>in vitro</i> fertilization with no lymphangioleiomyomatosis-related complication. The use of low-estrogen protocols and multidisciplinary collaboration are essential to ensure maternal–fetal safety and to minimize the risk of lymphangioleiomyomatosis progression during controlled ovarian hyperstimulation and pregnancy.</p>

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Successful live birth via in vitro fertilization in a patient with lymphangioleiomyomatosis: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月22日

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  • Yusen Ou,
  • Yanqiu Xie,
  • Xinyue Zhang,
  • Weilin Wang,
  • Yun Lin,
  • Yequn Chen,
  • Haiying Wang,
  • Yang Zeng

摘要

Background

Lymphangioleiomyomatosis is a rare, estrogen-sensitive multisystem disorder that predominantly affects women of reproductive age. Pregnancy and fertility interventions present a unique challenge in patients with lymphangioleiomyomatosis, as an elevated estrogen level during controlled ovarian hyperstimulation and pregnancy may exacerbate the disease.

Case presentation

We describe a 43-year-old Han Chinese female patient diagnosed with sporadic lymphangioleiomyomatosis because of recurrent pneumothorax and diminished ovarian reserve who had a strong desire for pregnancy. In vitro fertilization was considered the most effective treatment to improve pregnancy rate, with low-estrogen protocols recommended following a comprehensive multidisciplinary evaluation. In the first controlled ovarian hyperstimulation cycle, the patient was treated with a microstimulation protocol, resulting in a peak estradiol level of 621 pg/ml. Two fresh embryos were transferred but did not achieve pregnancy. In the second controlled ovarian hyperstimulation cycle, a combination of letrozole and antagonist protocol was used, with a peak estradiol level of 248 pg/ml. Endometrial preparation for the frozen embryo transfer was conducted using a natural cycle, leading to a successful pregnancy. Throughout the pregnancy, multidisciplinary collaboration ensured continuous monitoring of both lung function and fetal development. Eventually, she achieved a full-term live birth via elective cesarean section, and pulmonary parameters remained stable after pregnancy.

Conclusion

This is the first case report presenting a female diagnosed with sporadic lymphangioleiomyomatosis and diminished ovarian reserve who successfully achieved a live birth via in vitro fertilization with no lymphangioleiomyomatosis-related complication. The use of low-estrogen protocols and multidisciplinary collaboration are essential to ensure maternal–fetal safety and to minimize the risk of lymphangioleiomyomatosis progression during controlled ovarian hyperstimulation and pregnancy.