The effect of treatment with growth hormone on fertility outcome in eugonadal women with growth hormone deficiency: report of four cases and review of the literature

Alfredo Pontecorvi, Antonella Giampietro, Domenico Milardi, Antonio Bianchi, Alessandra Fusco, Riccardo Marana, Laura De Marinis Grasso, V Cimino, D Valle

Risultato della ricerca: Contributo in rivistaArticolo in rivista

32 Citazioni (Scopus)

Abstract

Objective: To highlight the clinical role of standard GH replacement treatment on fertility and pregnancy outcomes in four infertile eugonadal women with GH deficiency (GHD). Design: Case report. Setting: Department of endocrinology and infertility clinic, tertiary-care university hospital. Patient(s): Four normogonadotrophic, normoprolactinemic patients with long-standing infertility, affected by GHD. In two patients (aged 30 and 34 years) GHD was diagnosed after a brain injury. The third patient (age 30 years) had a primary empty sella, documented by magnetic resonance imaging of the pituitary. The last patient (age 28 years) underwent transsphenoidal surgery for Ratke's cyst. The LH and FSH responses to GnRH were normal in all four patients. Two of the four patients also had secondary hypoadrenalism and hypothyroidism. Intervention(s): Patients received recombinant human GH replacement therapy (0.9-1.8 mg/week) for 6-12 months until pregnancy was first indicated by biochemical markers (β-hCG) and later confirmed by transvaginal sonography. The GH therapy was discontinued after confirmation of pregnancy. Main Outcome Measure(s): Pregnancy. Result(s): All patients remained off treatment throughout pregnancy; they had uneventful pregnancies and term deliveries. The babies were healthy and normal in terms of length and weight. Conclusion(s): Our case studies confirm the important clinical role of the GH-insulin-like growth factor I system in oocyte fertilization and the beginning of pregnancy in a selected population of eugonadotrophic infertile women. © 2009 American Society for Reproductive Medicine.
Lingua originaleEnglish
pagine (da-a)930.e7-930.e7-930.e11
RivistaFertility and Sterility
Volume91
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Adult
  • Drug Administration Schedule
  • Female
  • Fertility
  • Follicle Stimulating Hormone, Human
  • Gonadotropin-Releasing Hormone
  • Hormone Replacement Therapy
  • Human Growth Hormone
  • Humans
  • Hypopituitarism
  • Hypothyroidism
  • Infant, Newborn
  • Infertility, Female
  • Live Birth
  • Luteinizing Hormone
  • Male
  • Pregnancy
  • Rathke cleft cyst
  • Recombinant Proteins
  • arginine
  • article
  • brain injury
  • case report
  • chorionic gonadotropin beta subunit
  • drug effect
  • empty sella syndrome
  • female
  • female infertility
  • follitropin
  • gonadorelin
  • growth hormone deficiency
  • hormone substitution
  • human
  • human growth hormone
  • hyperadrenocorticism
  • hypothyroidism
  • luteinizing hormone
  • nuclear magnetic resonance imaging
  • ovulation induction
  • pregnancy
  • pregnancy outcome
  • priority journal
  • somatomedin C, adult
  • term birth
  • tertiary health care
  • transsphenoidal surgery
  • treatment duration
  • treatment withdrawal
  • university hospital, Adrenal Insufficiency

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