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Objective: To describe ovulation induction and pregnancy outcome in a unique model of genetically determined combined pituitary hormone deficiency (CPHD), with respect to the necessity for GH substitution therapy. Design: Case report. Setting: Academic units. Patient(s): Two patients with childhood onset of CPHD (GH, PRL, TSH, LH, FSH) caused by a genetic defect (GA296del mutation) of the Prop1 gene. Main Outcome Measure(s): Ovulation, pregnancy outcome, and fetal growth. Result(s): Successful pregnancy outcome and delivery of normal, full-term newborns were achieved in both patients with the use of gonadotropins and L-T, Growth hormone supplementation was not necessary. No lactation was observed. Conclusion(s): Patients with Prop1 gene mutations constitute a unique model for studying the role of GH and PRL in ovulation, pregnancy, and fetal growth. Our data indicate that for women with CPHD, ovulation and pregnancy are possible with a classic regimen for hypogonadotropic hypogonadism, without the need for GH substitution therapy. (Fertil Steril((R)) 2004;82:454-7. (C) 2004 by American Society for Reproductive Medicine.). |
