Management of infertility in a patient presenting with ovarian dysfunction and McCune-Albright syndrome.
Persistent autonomous ovarian dysfunction in McCune-Albright syndrome (MAS) patients is associated with the development of multiple dominant follicles, premature luteinization, cyst formation, and anovulatory infertility. Due to the mosaic distribution of the mutation, ovaries may be unequally affected. In the current patient, the least affected ovary became quiescent upon GnRH agonist-induced gonadotropin suppression. Normoovulatory cycles were restored after subsequent removal of the affected right ovary, and a pregnancy was established within 3 months. A healthy unaffected girl was born at term after an uneventful pregnancy. The placental tissue was normal, and the mutation was not detected in the placenta, umbilical cord structures, or umbilical cord blood. GnRH analog administration may help to identify those MAS patients who might benefit from unilateral ovariectomy. Because a healthy baby was born, evidence is provided suggesting that MAS is not passed on to the children from the parents.
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands. j.laven@erasmusmc.nl
Joop S E
JS
Laven
Serge
S
Lumbroso
Charles
C
Sultan
Bart C J M
BC
Fauser
D000328:Adult; D004717:Endometrium / Q000503:physiopathology; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000150:complications* / Q000235:genetics; D007987:Gonadotropin-Releasing Hormone / Q000235:genetics; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D010052:Ovariectomy; D010053:Ovary / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome
D007987:Gonadotropin-Releasing Hormone