Adjuvant Growth Hormone for Ovulation Induction with Gonadotropins in the Treatment of a Woman with Hypopituitarism

Abstract EN

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.