Management of infertility in women with hypogonadotropic hypogonadism
Bry-Gauillard, Hélène
Management of infertility in women with hypogonadotropic hypogonadism - 2023.
31
Hypogonadotropic hypogonadism is caused by a deficit or a dysfunction of the gonadotropic axis, resulting in anovulation. The deficit may be total, with collapsed gonadotropins, or partial, with a less marked hormonal picture. Hypogonadism may be congenital, as in Kallmann syndrome, or acquired secondary to hypothalamic-pituitary pathologies, for example. Management of infertility depends on the etiology of hypogonadism, but also on any associated subfertility factors, which should be systematically investigated before ovulation is induced. This review discusses treatments specific to certain etiologies, such as hyperprolactinemia and hypothalamic amenorrhea, and the particularities of ovulation induction in hypogonadotropic hypogonadism. Ovulation induction with gonadotropins can, in some cases, be difficult to manage, due to the difficulty of achieving monofollicular recruitment. The prognosis for pregnancy is generally excellent, even in cases of complete hypogonadism or hypogonadism associated with other pituitary deficiencies.
Management of infertility in women with hypogonadotropic hypogonadism - 2023.
31
Hypogonadotropic hypogonadism is caused by a deficit or a dysfunction of the gonadotropic axis, resulting in anovulation. The deficit may be total, with collapsed gonadotropins, or partial, with a less marked hormonal picture. Hypogonadism may be congenital, as in Kallmann syndrome, or acquired secondary to hypothalamic-pituitary pathologies, for example. Management of infertility depends on the etiology of hypogonadism, but also on any associated subfertility factors, which should be systematically investigated before ovulation is induced. This review discusses treatments specific to certain etiologies, such as hyperprolactinemia and hypothalamic amenorrhea, and the particularities of ovulation induction in hypogonadotropic hypogonadism. Ovulation induction with gonadotropins can, in some cases, be difficult to manage, due to the difficulty of achieving monofollicular recruitment. The prognosis for pregnancy is generally excellent, even in cases of complete hypogonadism or hypogonadism associated with other pituitary deficiencies.
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