title: Pregnancy after treatment with the insulin-sensitizing agent troglitazone in an obese woman with the hyperandrogenic, insulin-resistant acanthosis nigricans syndrome.
abstract: OBJECTIVE
  To report a case of unassisted pregnancy after 5 months of troglitazone treatment in a severely hyperandrogenic, insulin-resistant woman with acanthosis nigricans (HAIR-AN) previously managed with depot leuprolide acetate (LA) plus oral contraceptive and dexamethasone therapy.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Private infertility clinic.
  
  
  METHODS
  A 28-year-old African-American woman with excessive obesity (body mass index = 42 kg/m2) and HAIR-AN syndrome.
  
  
  METHODS
  Androgen suppression with depot LA plus oral contraceptive and dexamethasone therapy, troglitazone treatment resulting in normalization of fasting insulin and testosterone, spontaneous menses, and an unassisted pregnancy.
  
  
  METHODS
  Luteinizing hormone and testosterone concentrations, fasting insulin and glucose levels, insulin-glucose ratios, hCG levels, and ultrasound examinations.
  
  
  RESULTS
  Spontaneous menses followed by an intrauterine pregnancy after 5 months of treatment with troglitazone, an insulin-sensitizing agent, in a woman with severe HAIR-AN syndrome whose hyperandrogenism previously could be normalized only with depot LA plus oral contraceptive therapy and dexamethasone.
  
  
  CONCLUSIONS
  Troglitazone treatment resulted in attenuation of both hyperinsulinemia and hyperandrogenism in an obese woman with HAIR-AN and resulted in resumption of menses and a spontaneous pregnancy.
authors.affiliation: Center for Reproduction at Gramercy, MacGregor Medical Association, Houston, Texas 77025, USA. kh2196.americanmed.com.
authors.forename: K E
authors.initials: KE
authors.lastname: Elkind-Hirsch
authors.forename: R B
authors.initials: RB
authors.lastname: McWilliams
mesh_terms: D000052:Acanthosis Nigricans / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002839:Chromans / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D013844:Thiazoles / Q000627:therapeutic use*; D045162:Thiazolidinediones; D000077288:Troglitazone
chemical_list: D001786:Blood Glucose; D002839:Chromans; D012739:Gonadal Steroid Hormones; D007004:Hypoglycemic Agents; D007328:Insulin; D013844:Thiazoles; D045162:Thiazolidinediones; D000077288:Troglitazone