Kallmann's syndrome: pregnancy through intracytoplasmic sperm injection and complicated by gestational diabetes

Szilágyi, Antal; Mánfai, Zoltán; Kiesel, L.; Szabó, I.

doi:10.1080/713602922

Cited by 5 publications

(8 citation statements)

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“…Impaired semen quality prevented his spouse from conceiving and IVF helped the couple in having a healthy baby. Thereafter, some studies presented pregnancies achieved through IVF/ICSI in CHH patients not responding to hormonal treatment [ 9 , 10 ], and pregnancy rates from the large studies were 50–60% [ 11 , 12 ]. Gonadotropin replacement combined with TESE-ICSI cycles improved pregnancy rate of CHH patients [ 13 ], the clinical pregnancy rate was 17.6%.…”

Section: Discussionmentioning

confidence: 99%

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Gao

Mao

et al. 2018

BMC Endocr Disord

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BackgroundAfter hormonal replacement therapy (HRT) including androgen replacement or sequential therapy of estrogen and progesterone, The combination of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) and pulsatile GnRH, is not sufficient to produce sufficient gametes in some patients with Congenital hypogonadotropic hypogonadism (CHH). A Systematic review and meta-analysis was performed to determine that assisted reproductive techniques (ART) can effectively treat different causes of infertility.MethodsTo determine the effect of ART on fertility of CHH patients and investigate whether outcomes are similar to infertility due to other causes, we conducted a systematic review and meta-analysis of retrospective trials.Clinical trials were systematically searched in Medline, Embase, and the Cochrane central register of controlled trials databases. The keywords and major terms covered “hypogonadotropic hypogonadism”, “kallmann syndrome”, “assisted reproductive techniques”, “intrauterine insemination”, “intracytoplasmic sperm injection”, “testicular sperm extraction”, “in vitro fertilization”, “embryo transplantation” and “intra-Fallopian transfer”.ResultsA total of 388 pregnancies occurred among 709 CHH patients who received ART (effectiveness 46, 95% confidence interval 0.39 to 0.53) in the 20 studies we included. The I2 in trials assessing overall pregnancy rate (PR) per embryo transfer (ET) cycle was 73.06%. Similar results were observed in subgroup analysis by different gender. Regression indicates pregnancy rate decreases with increasing age. Fertilization, implantation and live birth rates (72, 36 and 40%) showed no significant differences as compared to infertility due to other causes.ConclusionsDespite CHH patients usually being difficult to generate gametes, their actual chances of fertility are similar to subjects with other non-obstructive infertility. ART is a suitable option for CHH patients who do not conceive after long-term gonadotropin treatment.Electronic supplementary materialThe online version of this article (10.1186/s12902-018-0313-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Gao

Mao

et al. 2018

BMC Endocr Disord

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“…Therefore, ovulation induction is essential for pregnancy in these cases. In the literature, a few deliveries have been reported for women with this syndrome undergoing ovulation induction by use of pulsatile GnRH [11], recombinant LH and FSH [12], hMG [13][14][15][16], and hMG then low-dose hCG [17].…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that fertilization success is improved by ICSI for cases in which fertilization failure occurred in a previous IVF cycle [18]. Only 1 delivery by use of ICSI for a woman with Kallmann syndrome has been reported [14]. Another delivery was achieved by IUI [17].…”

Section: Discussionmentioning

confidence: 99%

Successful pregnancy by vitrified–warmed embryo transfer for a woman with Kallmann syndrome

Shimoda¹,

Iwayama²,

Ishiyama³

et al. 2015

Reprod Medicine & Biology

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Purpose Kallmann syndrome is a genetic disorder characterized by hypogonadotropic hypogonadism and anosmia. We report the case of a 31-year-old woman with Kallmann syndrome who successfully gave birth after intracytoplasmic sperm injection (ICSI) and vitrifiedwarmed embryo transfer, despite relatively ineffective ovarian stimulation. Method A 30 year-old woman with primary amenorrhea wished to achieve pregnancy. Diagnostic testing results were consistent with Kallmann syndrome. Follicular stimulation was started with human menopausal gonadotropin (hMG; 150 IU/day). After 28 days of treatment, 4 follicles were observed (total hMG; 4200 IU), with a dominant follicle diameter of 23 mm. Ovum pick-up was performed and 2 oocytes, one at metaphase II (MII) and one at the germinal vesicle stage, were obtained. Piezo-ICSI was performed on the MII oocyte and an 8-cell stage embryo was cryopreserved on day 3. Subsequently, embryo transfer was performed after endometrial preparation. Result A gestational sac and embryo heart activity were confirmed by ultrasonographic monitoring, and a healthy male infant weighing 3246 g was delivered by Caesarean section after 41 weeks 3 days of gestation. Conclusion This is the first report of a healthy delivery after vitrified-warmed embryo transfer for a woman with Kallmann syndrome. Our experience suggests that ICSI and vitrified-warmed embryo transfer are effective for women with Kallmann syndrome.

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“…Another recent report suggests diabetes may occur in patients with Kallmann's syndrome, but further investigation is required to establish whether gestational diabetes is associated with the syndrome or was coincidental in this case. 45…”

Section: Can Art Influence the Development Of Diabetes?mentioning

confidence: 99%

Review: Diabetes and assisted reproductive technology

Taylor

2002

Diabetes & Vascular Disease

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Patients with a range of medical disorders, including diabetes mellitus, are increasingly seeking access to assisted reproductive technology (ART). With appropriate patient selection, monitoring and counselling, these technologies may be applied successfully. Diabetes in the female is associated with disturbed ovarian function but strict metabolic control may encourage resumption of ovulation and allow ovarian stimulation for ART. Insulin metabolism appears intimately involved with ovarian function, through mechanisms encompassing the actions of insulin-like growth factors, but is not yet fully understood. Diabetes has minimal effects on spermatogenesis but may severely disrupt erectile and/or ejaculatory function; the techniques of epididymal sperm aspiration and intracytoplasmic sperm injection (ICSI) are particularly useful in such cases. Well-controlled diabetes is not associated with recurrent miscarriage but diabetes is a risk factor for pregnancy-induced hypertension and, poorly controlled, is associated with neonatal macrosomia. In reproduction, as in general health, good metabolic control is key to a successful outcome.

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Kallmann's syndrome: pregnancy through intracytoplasmic sperm injection and complicated by gestational diabetes

Cited by 5 publications

References 0 publications

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Successful pregnancy by vitrified–warmed embryo transfer for a woman with Kallmann syndrome

Review: Diabetes and assisted reproductive technology

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