Fertility Issues in Hypopituitarism

Overview

Journal Rev Endocr Metab Disord

Publisher Springer

Specialty Endocrinology

Date 2023 Dec 14

PMID 38095806

Authors

Julie Chen

Julia J Chang

Esther H Chung

Ruth B Lathi

Lusine Aghajanova

Laurence Katznelson

Affiliations

Soon will be listed here.

Abstract

Women with hypopituitarism have lower fertility rates and worse pregnancy outcomes than women with normal pituitary function. These disparities exist despite the use of assisted reproductive technologies and hormone replacement. In women with hypogonadotropic hypogonadism, administration of exogenous gonadotropins can be used to successfully induce ovulation. Growth hormone replacement in the setting of growth hormone deficiency has been suggested to potentiate reproductive function, but its routine use in hypopituitary women remains unclear and warrants further study. In this review, we will discuss the clinical approach to fertility in a woman with hypopituitarism.

References

Kubler K, Klingmuller D, Gembruch U, Merz W . High-risk pregnancy management in women with hypopituitarism. J Perinatol. 2009; 29(2):89-95. DOI: 10.1038/jp.2008.116. View

Aulinas A, Stantonyonge N, Garcia-Patterson A, Adelantado J, Medina C, Espinos J . Hypopituitarism and pregnancy: clinical characteristics, management and pregnancy outcome. Pituitary. 2021; 25(2):275-284. PMC: 8894301. DOI: 10.1007/s11102-021-01196-7. View

Hall R, Manski-Nankervis J, Goni N, Davies M, Conway G . Fertility outcomes in women with hypopituitarism. Clin Endocrinol (Oxf). 2006; 65(1):71-4. DOI: 10.1111/j.1365-2265.2006.02550.x. View

Sonntag B, Nawroth F, Ludwig M, Bullmann C . Anti-Müllerian hormone in women with hypopituitarism diagnosed before or during adolescence. Reprod Biomed Online. 2012; 25(2):190-2. DOI: 10.1016/j.rbmo.2012.03.010. View

Correa F, Bianchi P, Franca M, Otto A, Rodrigues R, Ejzenberg D . Successful Pregnancies After Adequate Hormonal Replacement in Patients With Combined Pituitary Hormone Deficiencies. J Endocr Soc. 2017; 1(10):1322-1330. PMC: 5686689. DOI: 10.1210/js.2017-00005. View

Tsilchorozidou T, Conway G . Uterus size and ovarian morphology in women with isolated growth hormone deficiency, hypogonadotrophic hypogonadism and hypopituitarism. Clin Endocrinol (Oxf). 2004; 61(5):567-72. DOI: 10.1111/j.1365-2265.2004.02126.x. View

Kim H, Lee D, Yoon B, Choi D . Uterine Development After Estrogen Replacement Therapy in Women with Different Etiologies of Primary Hypogonadism. J Pediatr Adolesc Gynecol. 2015; 29(4):344-7. DOI: 10.1016/j.jpag.2015.11.011. View

Sowithayasakul P, Boekhoff S, Bison B, Muller H . Pregnancies after Childhood Craniopharyngioma: Results of KRANIOPHARYNGEOM 2000/2007 and Review of the Literature. Neuroendocrinology. 2020; 111(1-2):16-26. DOI: 10.1159/000506639. View

Overton C, Davis C, West C, Davies M, Conway G . High risk pregnancies in hypopituitary women. Hum Reprod. 2002; 17(6):1464-7. DOI: 10.1093/humrep/17.6.1464. View

10.

Shinar S, Many A, Maslovitz S . Questioning the role of pituitary oxytocin in parturition: spontaneous onset of labor in women with panhypopituitarism--a case series. Eur J Obstet Gynecol Reprod Biol. 2015; 197:83-5. DOI: 10.1016/j.ejogrb.2015.11.028. View

11.

Ghaffari F, Arabipoor A, Lankarani N, Etminan Z, Tehraninejad E . Assisted reproductive technique outcomes in hypogonadotropic hypogonadism women. Ann Saudi Med. 2013; 33(3):235-40. PMC: 6078534. DOI: 10.5144/0256-4947.2013.235. View

12.

Shoham Z, Balen A, Patel A, Jacobs H . Results of ovulation induction using human menopausal gonadotropin or purified follicle-stimulating hormone in hypogonadotropic hypogonadism patients. Fertil Steril. 1991; 56(6):1048-53. DOI: 10.1016/s0015-0282(16)54715-3. View

13.

White D, Polson D, Kiddy D, Sagle P, Watson H, Gilling-Smith C . Induction of ovulation with low-dose gonadotropins in polycystic ovary syndrome: an analysis of 109 pregnancies in 225 women. J Clin Endocrinol Metab. 1996; 81(11):3821-4. DOI: 10.1210/jcem.81.11.8923819. View

14.

Salle A, Klein M, Pascal-Vigneron V, Dousset B, Leclere J, Weryha G . Successful pregnancy and birth after sequential cotreatment with growth hormone and gonadotropins in a woman with panhypopituitarism: a new treatment protocol. Fertil Steril. 2000; 74(6):1248-50. DOI: 10.1016/s0015-0282(00)01619-8. View

15.

Li X, Shi W, Gao Y, Shi J, Li N, Bai H . Is duration of estrogen supplementation associated with clinical outcomes in frozen-thawed autologous single-blastocyst transfer cycles?. J Assist Reprod Genet. 2022; 39(5):1087-1094. PMC: 9107546. DOI: 10.1007/s10815-022-02481-5. View

16.

Harvey S . Extrapituitary growth hormone. Endocrine. 2010; 38(3):335-59. DOI: 10.1007/s12020-010-9403-8. View

17.

Barreca A, Artini P, Del Monte P, Ponzani P, Pasquini P, Cariola G . In vivo and in vitro effect of growth hormone on estradiol secretion by human granulosa cells. J Clin Endocrinol Metab. 1993; 77(1):61-7. DOI: 10.1210/jcem.77.1.8325961. View

18.

Foster C, Hashimoto N, Randolph Jr J, Beitins I . Comparison of growth hormone and insulin-like growth factor-I regulation of estradiol and progesterone production in human luteinized granulosa cells. Pediatr Res. 1995; 38(5):763-7. DOI: 10.1203/00006450-199511000-00021. View

19.

Kobayashi J, Mizunuma H, Kikuchi N, Liu X, Andoh K, Abe Y . Morphological assessment of the effect of growth hormone on preantral follicles from 11-day-old mice in an in vitro culture system. Biochem Biophys Res Commun. 2000; 268(1):36-41. DOI: 10.1006/bbrc.1999.2072. View

20.

de Boer J, van der Meer M, van der Veen E, Schoemaker J . Growth hormone (GH) substitution in hypogonadotropic, GH-deficient women decreases the follicle-stimulating hormone threshold for monofollicular growth. J Clin Endocrinol Metab. 1999; 84(2):590-5. DOI: 10.1210/jcem.84.2.5452. View