Successful Pregnancies After Adequate Hormonal Replacement in Patients With Combined Pituitary Hormone Deficiencies

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author CORREA, Fernanda A. FMUSP-HC
BIANCHI, Paulo H. M. FMUSP-HC
FRANCA, Marcela M.
OTTO, Aline P. FMUSP-HC
RODRIGUES, Rodrigo J. M.
EJZENBERG, Dani FMUSP-HC
SERAFINI, Paulo C. FMUSP-HC
BARACAT, Edmundo Chada FMUSP-HC
FRANCISCO, Rossana P. V. FMUSP-HC
BRITO, Vinicius N. FMUSP-HC
ARNHOLD, Ivo J. P. FMUSP-HC
MENDONCA, Berenice B. FMUSP-HC
CARVALHO, Luciani R. FMUSP-HC
dc.date.issued 2017
dc.identifier.citation JOURNAL OF THE ENDOCRINE SOCIETY, v.1, n.10, p.1322-1330, 2017
dc.identifier.issn 2472-1972
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/26197
dc.description.abstract Context: Women with hypopituitarism have lower pregnancy rates after ovulation induction. Associated pituitary hormone deficiencies might play a role in this poorer outcome. Objective: We evaluated fertility treatment and pregnancy outcomes in five women with childhoodonset combined pituitary hormone deficiencies (CPHD). Patients and Methods: Five women with CPHD were referred for fertility treatment after adequacy of hormone replacement was determined. Patients were subjected to controlled ovarian stimulation (COS) for timed intercourse, intrauterine insemination, or in vitro fertilization, according to the presence or absence of other infertility factors (male or tubal). Results: All women became pregnant. The number of COS attempts until pregnancy was achieved varied between 1 and 5. The duration of COS resulting in at least one dominant follicle varied between 9 and 28 days, and total gonadotropin consumed varied between 1200 and 3450 IU. Two patients with severely suppressed basal gonadotropin levels since an early age had a cancelled COS cycle. All pregnancies were singleton except one (monochorionic twin gestation). The gestational ages at birth ranged from 35 weeks to 39 weeks and 4 days; three patients underwent cesarean section, and two had vaginal deliveries. Only one newborn was small for gestational age (delivered at 35 weeks). Conclusion: Adequate hormonal replacement prior to ovarian stimulation resulted in successful pregnancies in patients with childhood-onset CPHD, indicating that hormone replacement, including growth hormone, is an important step prior to fertility treatments in these patients.
dc.description.sponsorship · National Council of Technological and Scientific Development-Brazil grants [CNPq-PQ 305743/2011-2, CNPq-PQ 307922/2013-8]
· FAPESP Sao Paulo Research Foundation [2015/26563-7]
dc.language.iso eng
dc.publisher ENDOCRINE SOC
dc.relation.ispartof Journal of the Endocrine Society
dc.rights openAccess
dc.subject fertility; gonadotropin deficiency; growth hormone deficiency; hypopituitarism; IGF1; ovarian stimulation
dc.subject.other anti-mullerian hormone; growth-hormone; ovarian stimulation; gh deficiency; women; hypopituitarism; panhypopituitarism; outcomes; woman; ovulation
dc.title Successful Pregnancies After Adequate Hormonal Replacement in Patients With Combined Pituitary Hormone Deficiencies
dc.type article
dc.rights.holder Copyright ENDOCRINE SOC
dc.description.group LIM/42
dc.description.group LIM/57
dc.description.group LIM/58
dc.identifier.doi 10.1210/js.2017-00005
dc.identifier.pmid 29264457
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author CORREA, Fernanda A.:HC:ICESP
hcfmusp.author BIANCHI, Paulo H. M.:HC:ICHC
hcfmusp.author OTTO, Aline P.:HC:ICHC
hcfmusp.author EJZENBERG, Dani:HC:ICHC
hcfmusp.author SERAFINI, Paulo C.:FM:MOG
hcfmusp.author BARACAT, Edmundo Chada:FM:MOG
hcfmusp.author FRANCISCO, Rossana P. V.:FM:MOG
hcfmusp.author BRITO, Vinicius N.:HC:LIM/42
hcfmusp.author ARNHOLD, Ivo J. P.:HC:ICHC
hcfmusp.author MENDONCA, Berenice B.:FM:MCM
hcfmusp.author CARVALHO, Luciani R.:HC:ICHC
hcfmusp.author.external · FRANCA, Marcela M.:Univ Sao Paulo, Unidade Endocrinol Desenvolvimento, Lab Hormonios & Genet Mol LIM42, Hosp Clin,Disciplina Endocrinol,Fac Med, Ave Dr Eneas de Carvalho Aguiar 255, BR-05403900 Sao Paulo, Brazil
· RODRIGUES, Rodrigo J. M.:Univ Sao Paulo, Dept Obstet & Ginecol, Unidade Reprod Assistida & Infertilidade, Disciplina Ginecol,Fac Med, BR-05403900 Sao Paulo, Brazil
hcfmusp.origem.id WOS:000425352700010
hcfmusp.publisher.city WASHINGTON
hcfmusp.publisher.country USA
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dc.description.index WoS
hcfmusp.citation.wos 2
hcfmusp.affiliation.country Brasil


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