Successful Pregnancy in a Woman With Primary Infertility Associated With Isolated Hypogonadotropic Hypogonadism and Partial Empty Sella Syndrome: A Case Report.
This case report illustrates that individualized gonadotropin therapy may restore ovulation and lead to successful pregnancy in women with isolated hypogonadotropic hypogonadism and partial empty sella syndrome.
Where it sits
this study against the rest of the hmg (human menopausal gonadotropin) corpusSummary and findings
This case report describes a 34-year-old woman with 14 years of primary infertility due to isolated hypogonadotropic hypogonadism and partial empty sella syndrome. Hormonal assessment showed profound gonadotropin deficiency, and ovulation induction with human menopausal gonadotropin resulted in pregnancy after one stimulation cycle. A healthy male newborn was delivered via cesarean section at 38+3 weeks of gestation.
Abstract
Empty sella syndrome (ESS) is a radiological condition characterized by herniation of cerebrospinal fluid into the sella turcica, resulting in compression of the pituitary gland. Although often incidental, ESS may be associated with selective pituitary hormone deficiencies, including gonadotropin deficiency, leading to hypogonadotropic hypogonadism (HH) and infertility. We report the case of a 34-year-old woman with 14 years of primary infertility and a history of primary amenorrhea. Hormonal assessment revealed profound gonadotropin deficiency with a follicle-stimulating hormone (FSH) of 0.39 IU/L, luteinizing hormone (LH) less than 0.10 IU/L, and estradiol below 5 pg/mL, with preserved thyroid and prolactin function. Anti-Müllerian hormone (AMH) level was 0.8 ng/mL. Pituitary magnetic resonance imaging (MRI) demonstrated a partial empty sella without adenoma. Hysterosalpingography and semen analysis were normal. Ovulation induction with human menopausal gonadotropin resulted in pregnancy after one stimulation cycle. Cesarean section was performed at 38+3 weeks of gestation, delivering a healthy male newborn weighing 3180 g with an Apgar score of 10/10. Partial empty sella syndrome may be associated with isolated central hypogonadism leading to infertility, and individualized gonadotropin therapy can restore ovulation and achieve a successful pregnancy outcome.
Background
The paper addresses the clinical challenge of achieving pregnancy in women with primary infertility linked to isolated hypogonadotropic hypogonadism and partial empty sella syndrome. Prior literature has documented various treatment approaches for infertility, but successful outcomes in such specific cases remain limited. This study is significant as it presents a unique case that may contribute to the understanding of treatment options for similar patients.
Methods
This is a case report detailing the treatment of one woman with primary infertility. Specific details regarding the dosage of human menopausal gonadotropin (HMG), duration of treatment, and the exact methods used for monitoring outcomes are not provided in the abstract.
Results
Not reported in abstract.
Interpretation
The findings from this case report may not be directly comparable to larger studies or clinical trials due to the lack of quantitative data and the single-case nature of the report. The absence of control groups and statistical analysis limits the ability to draw robust conclusions about the effectiveness of HMG in this context. Therefore, while the case is noteworthy, it does not provide sufficient evidence to influence clinical practice broadly.
Key findings
- Not reported in abstract.
Limitations
- Single case report, limiting generalizability.
- No control group or statistical analysis provided.
- Lacks detailed treatment protocol and outcomes.
- Not applicable for clinical guidelines.