title: Adjuvant growth hormone for ovulation induction with gonadotropins in the treatment of a woman with hypopituitarism.
abstract: Objective. To report the prestimulation use of adjuvant GH for gonadotropin ovulation induction in a woman with hypopituitarism and GH deficiency who previously failed to respond. Design, Patients, and Measurements. A 31-year-old nulliparous woman presented with hypopituitarism and GH deficiency after failing ovulation induction with high dose gonadotropins. A trial of GH was undertaken for 5 months prior to ovulation induction resulting in normalization of IGF-I levels. Results. Women with hypopituitarism are known to have lower pregnancy rates after ovulation induction with need for higher doses of gonadotropins. A small subset of these patients do not ovulate. This patient had successful ovulation induction and pregnancy with prestimulation GH. Conclusions. This case suggests that the use of adjuvant GH in a GH-deficient patient several months before the use of human menopausal gonadotropin results in ovulation and pregnancy.
authors.affiliation: Department of Reproductive Endocrinology and Infertility, Mount Sinai Center for Fertility and Reproductive Health, 250 Dundas Street West, Suite 700, Toronto, ON, Canada M5T 2Z5.
authors.forename: Ariadne
authors.initials: A
authors.lastname: Daniel
authors.forename: Shereen
authors.initials: S
authors.lastname: Ezzat
authors.forename: Ellen
authors.initials: E
authors.lastname: Greenblatt