Ettore Caroppo1, Giuseppe D'Amato. 1. ASL Bari, IVF Unit, P.O. Conversano, Via Edmondo De Amicis 5, Conversano, Ba, Italy. ecaroppo@teseo.it
Abstract
PURPOSE: To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn's disease. METHOD: Here is reported the case of a 20 years old woman with Crohn's disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment. RESULTS: Corticosteroid treatment was ineffective in restoring patients gonadotropin levels as well as ovarian volume, while estro-progestins promoted a prompt reduction in gonadotrophin levels, which returned in the normal range after two years of treatment, as well as restoration of ovarian function, which occurred after four years of estrogens administration, as demonstrated by normal ovarian volume and ovulatory follicles at ultrasound, and by the re-establishment of regular menses after estroprogestin discontinuation. CONCLUSIONS: Long-term suppression of the endogenous gonadotropins using estroprogestins may be suggested as a treatment able to restore ovarian responsiveness even in patients with premature ovarian insufficiency showing highly elevated gonadotropin levels.
PURPOSE: To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn's disease. METHOD: Here is reported the case of a 20 years old woman with Crohn's disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment. RESULTS: Corticosteroid treatment was ineffective in restoring patients gonadotropin levels as well as ovarian volume, while estro-progestins promoted a prompt reduction in gonadotrophin levels, which returned in the normal range after two years of treatment, as well as restoration of ovarian function, which occurred after four years of estrogens administration, as demonstrated by normal ovarian volume and ovulatory follicles at ultrasound, and by the re-establishment of regular menses after estroprogestin discontinuation. CONCLUSIONS: Long-term suppression of the endogenous gonadotropins using estroprogestins may be suggested as a treatment able to restore ovarian responsiveness even in patients with premature ovarian insufficiency showing highly elevated gonadotropin levels.
Authors: Massimo Tartagni; Ettore Cicinelli; Giovanni De Pergola; Maria Antonietta De Salvia; Cristina Lavopa; Giuseppe Loverro Journal: Fertil Steril Date: 2007-01-29 Impact factor: 7.329
Authors: Ana Gordon; Rafaela Aguilar; José C Garrido-Gracia; Silvia Guil-Luna; Raquel Sánchez-Cespedes; Yolanda Millán; Juana Martín de las Mulas; José E Sánchez-Criado Journal: Hum Reprod Date: 2009-07-02 Impact factor: 6.918
Authors: P Barbarino-Monnier; B Gobert; F Guillet-May; M C Béné; A Barbarino; B Foliguet; G C Faure Journal: Hum Reprod Date: 1995-08 Impact factor: 6.918