Management of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism

Katılmış, Hüseyin; Bulut, Berk; Karacan, Tolga; Özyürek, Eser Şefik; Gedikbaşı, Ali; Apı, Murat

doi:10.1016/j.jogoh.2019.03.027

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…Higher gonadotropin doses are generally used than in patients with other causes of infertility [101]. Antral follicle count, ovarian volume and anti-Müllerian hormone levels are not useful to predict treatment response in women with HH [102].…”

Section: Long-term Effects Of Parasellar Lesion Treatments On Female mentioning

confidence: 99%

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

et al. 2020

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Central hypogonadism, also defined as hypogonadotropic hypogonadism, is a recognized complication of hypothalamic-pituitary-gonadal axis damage following treatment of sellar and parasellar masses. In addition to radiotherapy and surgery, CTLA4-blocking antibodies and alkylating agents such as temozolomide can also lead to hypogonadism, through different mechanisms. Central hypogonadism in boys and girls may lead to pubertal delay or arrest, impairing full development of the genitalia and secondary sexual characteristics. Alternatively, cranial irradiation or ectopic hormone production may instead cause early puberty, affecting hypothalamic control of the gonadostat. Given the reproductive risks, discussion of fertility preservation options and referral to reproductive specialists before treatment is essential. Steroid hormone replacement can interfere with other replacement therapies and may require specific dose adjustments. Adequate gonadotropin stimulation therapy may enable patients to restore gametogenesis and conceive spontaneously. When assisted reproductive technology is needed , protocols must be tailored to account for possible long-term gonadotropin insufficiency prior to stimulation. The aim of this review was to provide an overview of the risk factors for hypogonadism and infertility in patients treated for parasellar lesions and to give a summary of the current recommendations for management and follow-up of these dysfunctions in such patients. We have also briefly summarized evidence on the physiological role of pituitary hormones during pregnancy, focusing on the management of pituitary deficiencies.

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Section: Long-term Effects Of Parasellar Lesion Treatments On Female mentioning

confidence: 99%

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

et al. 2020

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“…Tadokoro et al have reported a pregnancy loss rate of 27% [17]. Huseyin et al also reported a pregnancy rate of 12.7% and 28.3% per cycle and per patient, respectively [5].…”

Section: Discussionmentioning

confidence: 98%

“…Primary hypogonadotropic hypogonadism is congenital whereas acquired causes of HH may include tumors, infiltrative diseases, infections and trauma. Idiopathic hypogonadotropic hypogonadism or Kallmans syndrome constitutes 1: 50,000 of infertile patients [5] and is notable for absence of pituitary tumor and is associated with other congenital abnormalities(cleft palate, renal agenesis, cardiac abnormality, abnormal platelet function) [4]. 27-45 percent of these women are anosmic or hyposmic [6,7].…”

Section: Discussionmentioning

confidence: 99%

Ovulation Induction and Intrauterine Insemination for Hypogonadotropic Hypogonadism

S¹,

Suri²,

Lk³

et al. 2021

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Hypogonadotropic Hypogonadism (HH) is a rare gynae- endocrinological cause of anovulatory infertility. Gonadotropins are given to induce ovulation. Various ART techniques have been used for assisting conception in these women. In this study, we aimed to calculate the chances of success of ovulation and pregnancy rates after ovulation induction and intrauterine seminal insemination in HH women. We reviewed and analyzed the chances of success of ovulation and conception with ovulation induction and intrauterine seminal insemination in thirty two couples who underwent 56 intrauterine insemination cycles. The average age of these women was 27.2+/- 3.2 years. Ovulation was documented in 55/56 cycles. An average of 12.89+/-5.05 days of stimulation was required to induce ovulation. The pregnancy rate was 50%. Thus, intrauterine insemination offers a cheaper yet good alternate option of reproductive techniques in addition to ovulation induction with gonadotropins, in hypogonadotropic hypogonadism, especially in the low resource settings.

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“…When fertility is desired, pulsatile GnRH administration or combined hCG (male)/recombinant LH (female) and FSH with assisted reproductive technology is introduced. 168 169 This approach has variable success rate. 169…”

Section: Endocrinopathies With Obesity Associationsmentioning

confidence: 99%

The Interaction of Obesity and Reproductive Function in Adolescents

et al. 2022

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Obesity is increasing worldwide, including in pediatrics. Adequate nutrition is required for initiation of menses, and there is a clear secular trend toward earlier pubertal onset and menarche in females in countries around the globe. Similar findings of earlier pubertal start are suggested in males. However, as individuals and populations have crossed into over-nutritional states including overweight and obesity, the effect of excess weight on disrupting reproductive function has become apparent. Hypothalamic hypogonadism and polycystic ovary syndrome are two conditions where reproductive function appears to directly relate to excess weight. Clinical findings in individuals with certain polygenic and monogenic obesity syndromes, which also have reproductive disruptions, have helped elucidate neurologic pathways that are common to both. Clinical endocrinopathies such as hypothyroidism or panhypopituitarism also aide in the understanding of the role of the endocrine system in weight gain. Understanding the intersection of obesity and reproductive function may lead to future therapies which can treat both conditions.

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Management of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism

Cited by 8 publications

References 16 publications

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

Ovulation Induction and Intrauterine Insemination for Hypogonadotropic Hypogonadism

The Interaction of Obesity and Reproductive Function in Adolescents

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