A Clinical Pregnancy Case of a PCOS Patient Treated with a Long Protocol Combined with Artificial Insemination (AIH)

To report a case of a polycystic ovary syndrome (PCOS) patient who successfully conceived after treatment with a long protocol combined with artificial insemination (AIH). A retrospective summary and analysis were conducted on a PCOS patient who had undergone three previous unsuccessful AIH attempts, declined in vitro fertilization-embryo transfer (IVF-ET) assistance, and successfully conceived after the fourth AIH treatment. The patient was treated with a GnRH agonist (GnRHa) long protocol and human menopausal gonadotropin (HMG) for controlled ovarian hyperstimulation. On day 4 of her menstrual cycle, she received 3.75mg of Beiyi (a GnRH agonist) for pituitary downregulation. On day 53 of downregulation, HMG was administered intramuscularly to initiate the stimulation cycle. When the follicle diameter reached 17.5mm, one dose of Aize was injected subcutaneously at 8 PM, and AIH was performed approximately 39 hours later. The patient successfully conceived 14 days later and delivered a healthy female infant via cesarean section at 40 weeks of gestation. For PCOS patients, conventional ovulation induction protocols are commonly used. If conventional ovulation induction and multiple attempts of guided intercourse or AIH in the outpatient setting fail, and the patient declines IVF-ET, adopting a long protocol combined with AIH represents a novel approach. Based on the natural follicular development pattern, accurate identification of the degree of pituitary-ovarian axis downregulation, appropriate use of downregulation dosage and timing, and flexible selection of GnRH initiation time can help these patients achieve the optimal assisted reproduction method.