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

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Tipo de produção
article
Data de publicação
2017
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ISSN da Revista
Título do Volume
Editora
ENDOCRINE SOC
Citação
JOURNAL OF THE ENDOCRINE SOCIETY, v.1, n.10, p.1322-1330, 2017
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Resumo
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.
Palavras-chave
fertility, gonadotropin deficiency, growth hormone deficiency, hypopituitarism, IGF1, ovarian stimulation
Referências
  1. Almog B, 2011, FERTIL STERIL, V95, P663, DOI 10.1016/j.fertnstert.2010.08.047
  2. Monteleone PAA, 2016, REPROD BIOMED ONLINE, V33, P161, DOI 10.1016/j.rbmo.2016.04.011
  3. Ascoli Paola, 2006, Pituitary, V9, P335, DOI 10.1007/s11102-006-0416-5
  4. Broer SL, 2013, HUM REPROD UPDATE, V19, P26, DOI 10.1093/humupd/dms041
  5. Castinetti F, 2015, J ENDOCRINOL INVEST, V38, P1, DOI 10.1007/s40618-014-0141-2
  6. Daniel A, 2012, CASE REP ENDOCRINOL, DOI 10.1155/2012/356429
  7. deBoer JAM, 1997, CLIN ENDOCRINOL, V46, P681, DOI 10.1046/j.1365-2265.1997.1800999.x
  8. Deubzer B, 2014, J CLIN ENDOCR METAB, V99, pE1045, DOI 10.1210/jc.2013-4250
  9. Drakopoulos P, 2016, J REPROD MED, V61, P78
  10. Franca MM, 2010, J CLIN ENDOCR METAB, V95, pE384, DOI 10.1210/jc.2010-1050
  11. FRANKENNE F, 1988, J CLIN ENDOCR METAB, V66, P1171, DOI 10.1210/jcem-66-6-1171
  12. Hall R, 2006, CLIN ENDOCRINOL, V65, P71, DOI 10.1111/j.1365-2265.2006.02550.x
  13. HOMBURG R, 1989, BRIT MED J, V298, P809, DOI 10.1136/bmj.298.6676.809
  14. Karaca Z, 2011, BEST PRACT RES CL EN, V25, P897, DOI 10.1016/j.beem.2011.07.006
  15. Kubler K, 2009, J PERINATOL, V29, P89, DOI 10.1038/jp.2008.116
  16. La Marca A, 2014, HUM REPROD UPDATE, V20, P124, DOI 10.1093/humupd/dmt037
  17. La Marca A, 2011, FERTIL STERIL, V95, P684, DOI 10.1016/j.fertnstert.2010.07.1069
  18. Milardi D, 2008, J Endocrinol Invest, V31, P71
  19. MULLER J, 1995, EUR J ENDOCRINOL, V132, P727, DOI 10.1530/eje.0.1320727
  20. Overton CE, 2002, HUM REPROD, V17, P1464, DOI 10.1093/humrep/17.6.1464
  21. Park JK, 2007, GYNECOL ENDOCRINOL, V23, P82, DOI 10.1080/09513590601137533
  22. Sakai S, 2011, ENDOCR J, V58, P65, DOI 10.1507/endocrj.K10E-208
  23. Salle A, 2000, FERTIL STERIL, V74, P1248, DOI 10.1016/S0015-0282(00)01619-8
  24. Sonntag B, 2012, REPROD BIOMED ONLINE, V25, P190, DOI 10.1016/j.rbmo.2012.03.010
  25. Tran ND, 2016, FERTIL STERIL, V105, P690, DOI 10.1016/j.fertnstert.2015.11.033
  26. Verhaeghe J, 2000, CLIN ENDOCRINOL, V53, P645, DOI 10.1046/j.1365-2265.2000.01044.x
  27. Vila G, 2015, FERTIL STERIL, V104, P1210, DOI 10.1016/j.fertnstert.2015.07.1132
  28. Wiren L, 2002, CLIN ENDOCRINOL, V57, P235, DOI 10.1046/j.1365-2265.2002.01572.x