Successful pregnancy and birth after sequential cotreatment with growth hormone and gonadotropins in a woman with panhypopituitarism: a new treatment protocol

Abstract 

Objective: To report a successful pregnancy in a woman with panhypopituitarism who received 3 months of pretreatment with growth hormone (GH) before ovulation induction. Prior attempts at ovulation induction had failed for this patient.

Design: Case report.

Setting: Department of Endocrinology.

Patient(s): A 32-year-old woman with panhypopituitarism and secondary infertility.

Intervention(s): GH (1 IU/day) alone for 3 months; during the next cycle, 1 IU/day of GH; 3 ampules of hMG per day during days 1–21; 1 ampule of hCG on day 21. GH was discontinued on day 35 when a pregnancy test was positive.

Main Outcome Measure(s): Pregnancy and delivery.

Results: Pregnancy and birth of a normal child after a single ovulation stimulation using GH and gonadotropins.

Conclusion(s): This case report suggests interest in a new protocol for follicular stimulation in women with hypopituitarism who are responding poorly to gonadotropin therapy.

Keywords:  GH, ovulation induction, gonadotropins, hypopituitarism, sterility, pregnancy