Multiple pregnancies following induction of ovulation

Schenker, Joseph G.; Yarkoni, Shai; Granat, Menachem

doi:10.1016/s0015-0282(16)46210-2

Cited by 83 publications

(48 citation statements)

References 92 publications

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“…Multiple pregnancies are a known complication of ovulation induction (25). However, when considering high risk pregnancies in patients with hypopituitarism, it has been suggested that fertility treatment must strive for singleton pregnancies with application of particular strict criteria to avoid multiple pregnancies (26).…”

Section: Discussionmentioning

confidence: 99%

Successful twin pregnancy in panhypopituitarism

Jeewantha

Perera²,

Wijeyaratne

et al. 2015

Sri Lanka J. Diabetes Endocrinol. Metab.

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CaseA 35 year old mother of one admitted from our antenatal clinic at 34 weeks of period of gestation for the tertiary care management of a dichorionic diamniotic (DCDA) twin pregnancy.At the age of 20 years, she was diagnosed to have a Rathke's pouch cyst, which was surgically drained and followed by radiotherapy. Post-interventional panhypopituitarism was diagnosed and she was on hormone replacement for hypocortisolism, hypothyroidism and hypopogonadotropic hypogonadism; while growth hormone was not replaced due to lack of funding. She was replaced with oral levo-thyroxine, hydrocortisone (20mg daily in split doses) and the combined oral contraceptive pill (OCP). The patient remained symptomfree and returned to full time work. Upon her request, at the age of 28 years as fertility treatment, induction of ovulation with gonadotrophins was done. During the second cycle of treatment with recombinant FSH for follicular development and maturation with subsequent human chorionic gonadotrophin (hCG) for ovulation following ultrasound ovum tracking coupled, with Intra Uterine Insemination (IUI) resulted in a singleton intrauterine pregnancy. AbstractPanhypopituitarism is characterized by inadequate or absent production of anterior pituitary hormones. This involves hypofunction of most of the major endocrine functions that affect fertility and reproduction. Deficiency of all six anterior pituitary hormones leads to deficiencies of gonadotrophins (FSH, LH), thyroid axis (TSH), adrenocortical hormones (ACTH), Growth Hormone (GH) and Prolactin (PRL). GH and gonadotrophin deficiency are commoner (1) than TSH and ACTH deficiency (2).Although pregnancy after complete loss of pituitary function is uncommon, advances in fertility treatment have led to increased pregnancy rates in these women. Problems related to pregnancy include infertility, lactation failure and increased risk of complications such as miscarriage, anaemia, pregnancy-induced hypertension, placental abruption, premature birth, and postpartum hemorrhage (3,4,5). Conception in this group of patients usually requires the support of assisted reproductive techniques. Induction of ovulation by means of human or recombinant gonadotrophins is widely used in current practice. Progestrogen support following conception, optimizing other hormonal replacement and careful monitoring throughout pregnancy play a vital role in successful pregnancy outcomes. We report a subject with panhypopituitarism who was managed in our Endocrine Antenatal clinic with successful outcome.

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Section: Discussionmentioning

confidence: 99%

Successful twin pregnancy in panhypopituitarism

Jeewantha

Perera²,

Wijeyaratne

et al. 2015

Sri Lanka J. Diabetes Endocrinol. Metab.

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“…Previous studies have showed that the rate of multiple fetal implantations is 7.5-29% (ref. 9 ) in patients receiving IUI and ovarian stimulation 10 . Most previous studies which compared the pregnancy rate between the IVF group and the conversion from IUI to IVF group reported that the clinical pregnancy rate was similar between the two groups.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of conversion from IUI to IVF-ET in infertility patients with hyper-response to ovulation induction: A retrospective study

Zhong¹,

Li²,

Ying³

et al. 2012

BIOMED PAP

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Background. The aim of the study was to determine the efficacy of in vitro fertilization and embryo transfer (IVF-ET) in patients with hyper-response to ovulation induction for intrauterine insemination (IUI). Methods. Patients with polycystic ovary syndrome (PCOS) who were initially treated with IUI in our centre between Jan 2007 and Oct 2010 were retrospectively analyzed. The ovarian hyper-stimulation syndrome (OHSS) found in 50 patients was then treated with IVF-ET following informed consent. Results. The fresh transfer had 42 cycles and a total of 87 embryos were transferred. Urine pregnancy tests were positive in 15 patients and fetal heart beat was detected in 12 patients by transvaginal ultrasound, from which 3 patients had two fetuses, 2 patients had three fetuses, and 7 patients had a single fetus. The overall clinical pregnancy rate was 28.5% (12/42) for the fresh embryo transfer. A total of 21 cycles of frozen embryo transfer with up to 55 embryos were conducted for patients who were not pregnant at the end of fresh embryo transfer cycles or who did not receive fresh embryo transfer in the first place. Urine pregnancy tests were positive in 10 patients and fetal heart beat was detected in 8 patients. The clinical pregnancy rate was 38.1% (8/21) for frozen embryo transfer. Conclusion. We conclude that IVF-ET is an effective method for patients with hyper-response to ovulation induction in IUI.

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“…Our study shown that out of 75 cases of twin gestation, 70 (93.3%) patients were conceived naturally and 5 (6.66%) patients were conceived after ovulation induction with clomiphene citrate or human chronic gonadotrophins. Schenker, J. G et al, (1981) [20] concluded that the incidence of multifoetal pregnancies after induction of ovulation with clomiphene was between 6.8% and 17%. Following induction of ovulation with gonadotrophines, the incidence of multifoetal gestation was between 18% and 53%.…”

Section: No Of Casesmentioning

confidence: 99%

A Study on the Maternal and Foetal Outcome of Twin Pregnancy

Perween¹

2017

JMSCR

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Multiple pregnancies following induction of ovulation

Cited by 83 publications

References 92 publications

Successful twin pregnancy in panhypopituitarism

Successful twin pregnancy in panhypopituitarism

The efficacy of conversion from IUI to IVF-ET in infertility patients with hyper-response to ovulation induction: A retrospective study

A Study on the Maternal and Foetal Outcome of Twin Pregnancy

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