Women with hypogonadotropic hypogonadism: cycle characteristics and results of assisted reproductive techniques.
OBJECTIVE
To present cycle characteristics and results of in vitro fertilization in 27 patients with hypogonadotropic hypogonadism. Further, to demonstrate the consequences of advanced age (> or =35 years).


METHODS
Data from 27 hypogonadotropic hypogonadism patients treated with in vitro fertilization in the period from 2000 to 2004 were analyzed and compared with treatment results from 39 patients with unexplained infertility. Moreover, data from hypogonadotropic hypogonadism patients were analyzed according to the age factor. Mann-Whitney U, Chi-square, and Student's t-tests were used for statistical analysis. p<0.05 was considered significant.


RESULTS
Higher gonadotropin consumption and a longer stimulation period were observed in the hypogonadotropic hypogonadism group. Peak E2 levels, and the total number of oocytes and metaphase II oocytes were higher in the unexplained infertility group. Although a higher number of grade I embryos were transferred in the unexplained infertility group, the implantation rate was found to be better in the hypogonadotropic hypogonadism group (36.5% versus 13%; p<0.0001). Pregnancy rates were similar. When hypogonadotropic hypogonadism patients were evaluated according to the age factor, no significant difference was found with regard to cycle and outcome parameters, except higher gonadotropin consumption in aged patients. In aged hypogonadotropic hypogonadism patients, a pregnancy rate of 50% was achieved.


CONCLUSIONS
Hypogonadotropic hypogonadism women undergoing in vitro fertilization were found to be good responders. In the presence of advanced age, management of these patients becomes challenging. However, even these patients still have a good chance of pregnancy.
Kumbak
Banu
B
Istanbul Memorial Hospital, ART and Genetics Center, Istanbul, Turkey. bkumbak@yahoo.com
Kahraman
Semra
S
D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D008597:Menstrual Cycle / Q000502:physiology*; D009865:Oocytes / Q000502:physiology; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D004958:Estradiol; D005640:Follicle Stimulating Hormone