Adjuvant Growth Hormone for Ovulation Induction with Gonadotropins in the Treatment of a Woman with HypopituitarismReport as inadecuate

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Case Reports in EndocrinologyVolume 2012 2012, Article ID 356429, 3 pages

Case Report

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

Division of Endocrine Oncology, University Health Network, 585 University Avenue, Toronto, ON, Canada M5N 2N2

Received 2 May 2012; Accepted 26 June 2012

Academic Editors: G. Aimaretti, J. P. Frindik, and A. J. O-Sullivan

Copyright © 2012 Ariadne Daniel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Author: Ariadne Daniel, Shereen Ezzat, and Ellen Greenblatt



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