IVF/ICSI in a woman with active acromegaly: successful outcome following treatment with pegvisomant.
A 29 year old woman with difficult to control acromegaly and a pituitary macroadenoma responded to pegvisomant therapy and subsequently conceived with her first cycle of in-vitro fertilization and intra-cytoplasmic sperm injection. Pregnancy was complicated by gestational diabetes, pituitary gland enlargement and deteriorating visual fields. Conservative management with elective cesarean section was performed at 32 weeks gestation. A healthy boy was delivered who remains developmentally normal at 1 year. This complex case required intricate care by a multi-disciplinary team and is likely to represent the first in many cases of assisted conception on pegvisomant therapy for active acromegaly.
Qureshi
Asjid
A
Department of Diabetes and Endocrinology, Northwick Park Hospital, Watford Road, Harrow, Middlesex, London, UK. asjid.qureshi@nwlh.nhs.uk
Kalu
Emmanuel
E
Ramanathan
Gowri
G
Bano
Gul
G
Croucher
Carolyn
C
Panahloo
Arshia
A
D000172:Acromegaly / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D019382:Human Growth Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging; D010902:Pituitary Gland / Q000473:pathology; D020554:Sperm Injections, Intracytoplasmic
D019382:Human Growth Hormone; C406545:pegvisomant