The effect of treatment with growth hormone on fertility outcome in eugonadal women with growth hormone deficiency: report of four cases and review of the literature.
OBJECTIVE
To highlight the clinical role of standard GH replacement treatment on fertility and pregnancy outcomes in four infertile eugonadal women with GH deficiency (GHD).


METHODS
Case report.


METHODS
Department of endocrinology and infertility clinic, tertiary-care university hospital.


METHODS
Four normogonadotrophic, normoprolactinemic patients with long-standing infertility, affected by GHD. In two patients (aged 30 and 34 years) GHD was diagnosed after a brain injury. The third patient (age 30 years) had a primary empty sella, documented by magnetic resonance imaging of the pituitary. The last patient (age 28 years) underwent transsphenoidal surgery for Ratke's cyst. The LH and FSH responses to GnRH were normal in all four patients. Two of the four patients also had secondary hypoadrenalism and hypothyroidism.


METHODS
Patients received recombinant human GH replacement therapy (0.9-1.8 mg/week) for 6-12 months until pregnancy was first indicated by biochemical markers (beta-hCG) and later confirmed by transvaginal sonography. The GH therapy was discontinued after confirmation of pregnancy.


METHODS
Pregnancy.


RESULTS
All patients remained off treatment throughout pregnancy; they had uneventful pregnancies and term deliveries. The babies were healthy and normal in terms of length and weight.


CONCLUSIONS
Our case studies confirm the important clinical role of the GH-insulin-like growth factor I system in oocyte fertilization and the beginning of pregnancy in a selected population of eugonadotrophic infertile women.
Giampietro
Antonella
A
Department of Gynecology and Obstetrics, International Scientific Institute Paolo VI, Catholic University, Rome, Italy.
Milardi
Domenico
D
Bianchi
Antonio
A
Fusco
Alessandra
A
Cimino
Vincenzo
V
Valle
Domenico
D
Marana
Riccardo
R
Pontecorvi
Alfredo
A
De Marinis
Laura
L
D000309:Adrenal Insufficiency / Q000188:drug therapy / Q000503:physiopathology; D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D005298:Fertility / Q000187:drug effects*; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D007987:Gonadotropin-Releasing Hormone; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000503:physiopathology; D007037:Hypothyroidism / Q000188:drug therapy / Q000503:physiopathology; D007231:Infant, Newborn; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D050498:Live Birth; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage
D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone