Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn's disease and premature ovarian insufficiency: a case report.
OBJECTIVE
To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn's disease.


METHODS
Here is reported the case of a 20 years old woman with Crohn's disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment.


RESULTS
Corticosteroid treatment was ineffective in restoring patients gonadotropin levels as well as ovarian volume, while estro-progestins promoted a prompt reduction in gonadotrophin levels, which returned in the normal range after two years of treatment, as well as restoration of ovarian function, which occurred after four years of estrogens administration, as demonstrated by normal ovarian volume and ovulatory follicles at ultrasound, and by the re-establishment of regular menses after estroprogestin discontinuation.


CONCLUSIONS
Long-term suppression of the endogenous gonadotropins using estroprogestins may be suggested as a treatment able to restore ovarian responsiveness even in patients with premature ovarian insufficiency showing highly elevated gonadotropin levels.
ASL Bari, IVF Unit, P.O. Conversano, Via Edmondo De Amicis 5, Conversano, Ba, Italy. ecaroppo@teseo.it
Ettore
E
Caroppo
Giuseppe
G
D'Amato
D000328:Adult; D000568:Amenorrhea / Q000473:pathology; D003424:Crohn Disease / Q000473:pathology*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009652:Norpregnenes / Q000494:pharmacology*; D010053:Ovary / Q000187:drug effects* / Q000473:pathology; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D004338:Drug Combinations; D009652:Norpregnenes; C494367:estroprogestin; C033273:Gestodene; D004997:Ethinyl Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone