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Infertility Treatment Results In Hypogonadotropic Hypogonadism Cases

Yıl 2016, Cilt: 13 Sayı: 4, 160 - 163, 01.10.2016

Öz

Aim: We aimed to determine the response to treatment of in vitro fertilization IVF / intracytoplasmic sperm injection ICSI on infertile female patients with hypogonadotropic hypogonadism HH .Material and Methods: 20 HH patients treated with IVF/ICSI in the period from 2009 until 2014 in Zeynep Kamil Women and Children Diseases Hospital IVF clinic were analyzed and compared with KOS / ICSI treatment results from 45 patients in our clinic in 2013 with unexplained infertility.Patients with low ovarian reserve were excluded. Follicular development, biochemical pregnancy, clinical pregnancy outcome, live birth outcomes were evaluated retrospectively.Results: The total dose of gonadotropin, implantation rate, grade 1-2 embryo rate and live birth rate was significantly higher in the HH group, while M2 oocytes number, the number of fertilized oocytes and fertilization rate was significantly higher in Uİ group. Serum estradiol level on the day of HCG, the collected total number of oocytes, oocyte ratio of M2, the number of Grade 1-2 embryos, number of embryos transferred were similar in both groups.Conclusions: In our study we concluded that HH patients respond well on treatment of IVF/ICSI as assisted reproductive techniques and successful reproductive outcomes can be obtained with high doses of gonadotropin therapy.

Kaynakça

  • Matsumoto AM, Snyder PJ, Bhasin S et al. Stimulation of spermatogene- sis with recombinant human follicle-stimulating hormone (follitropin alfa; GONAL-f): long-term treatment in azoospermic men with hypogonadot- ropic hypogonadism. Fertil Steril 2009; 92: 979–990.
  • Ulug U, Shlomo I. The reproductive performance of women with hypo- gonadotropic hypogonadismin an in vitro fertilization and embriyo trans- fer program. Journal of Assisted Reprod and Genetics 2005;22:167-71.
  • Yilmaz S, Ozgu-Erdinc AS. The reproductive outcome of women with hypogonadotropic hypogonadism undergoing in vitro fertilization. Syst Biol Reprod Med. 2015;61:228-32.
  • Shoham Z, Balen A, Patel A, Jacobs HS. Results of ovulation induction using human menopausal gonadotropin or purified follicle-stimulating hormone in hypogonadotropic hypogonadism patients. Fertil Steril 1991; 56: 1048–1053.
  • Balasch J, Miro F, Burzaco I, Casamitjana R, Civico S, Ballesca JL, et al. The role of luteinizing hormone in human follicle development and oocyte fertility: evidence from IVF in a woman with long-standing hypogonadot- rophic hypogonadism and using rFSH. Hum Reprod. 1995; 10: 1678-83.
  • Burgues S. The effectiveness and safety of recombinant human LH to support follicular development induced by recombinant human FSH in WHO group I anovulation: evidence from a multicentre study in Spain. Hum Reprod 2001; 16: 2525–2532.
  • Veeck LL. Atlas of the Human Oocyte and Early Conceptus. Baltimore, Williams&Wilkins,1986.
  • Skalba P, Guz M.Hypogonadotropic hypogonadism in women. Endokry- nol Pol. 2011;62:560-7.
  • Balen AH, Braat DD, West C, Patel A, Jacobs HS. Cumulative concep- tion and live birth rates after the treatment of anovulatory infertility: safety and efficacy of ovulation induction in 200 patients.Hum Reprod. 1994;9:1563-70.
  • Lahoud R, Al-Jefout M, Tyler J, Ryan J, Driscoll G. A relative reduction in mid-follicular LH concentrations during GnRH agonist IVF/ICSI cycles leads to lower live birth rates.Hum Reprod. 2006;21:2645-9.
  • Westergaard LG, Laursen SB, Andersen CY. Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction. Hum Reprod. 2000;15:1003-8.
  • Kumbak B, Kahraman S. Women with hypogonadotropic hypogonadism: cycle characteristics and results of assisted reproductive techniques. Acta Obstet et Gynecol.2006;85:1453-57.
  • Ghaffari F, Arabipoor A.Assisted reproductive technique outcomes in hy- pogonadotropic hypogonadism women. Ann Saudi Med 2013; 33: 235- 240.
  • Lewit N, Shahar K. The low responder hypogonadotropic hypogonadism female patient in IVF: do not give up Fertil Steril. 2000;74:401-2.
  • Liu S, Feng HL. Dose-dependent effects of gonadotropin on oocyte deve- lopmental competence and apoptosis. Reprod Fertil Dev. 2011;23:990- 6.
  • Sönmezer M, Özmen B, Atabekoglu CS, Papuccu EG, Ozkavukcu S, Ber- ker B, Pabuccu R.Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism.J Assist Reprod Genet. 2012 ;29:597-602.

Hipogonadotropik Hipogonadizm Olgularında İnfertilite Tedavisi Sonuçları

Yıl 2016, Cilt: 13 Sayı: 4, 160 - 163, 01.10.2016

Öz

Amaç: Hipogonadotropik hipogonadizmi HH bulunan infertil kadın hastaların kontrollü ovaryan stimulasyon KOS /intrasitoplazmik sperm injeksiyonu ICSI tedavisine verdikleri cevabı saptamayı amaçladık.Gereç ve Yöntemler: Bu çalışmaya 2009- 2014 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Hastanesi’nde tüp bebek kliniğindeKOS/ICSI tedavisi yapılmış 20 HH tanısı alan bayan hasta dahil edildi.Kontrol grubu olarak, kliniğimizde açıklanamayan infertilite Aİ nedeniyle 2013 yılında KOS/ICSI tedavisi yapılmış ardışık 45 hasta dahil edildi. Düşük ovaryan rezervi olan hastalar çalışma dışı bırakıldı. Retrospektif olarak folikül gelişimleri, biyokimyasal gebelik, klinik gebelik sonuçları, canlı doğum sonuçları değerlendirildi.Bulgular: HH grubunda toplam gonadotropin dozu, Grade 1-2 embriyo oranı, implantasyon oranı ve canlı doğum oranı anlamlı olarak yüksek bulunmuş, Aİ grubunda ise M2 oosit sayısı, fertilize oosit sayısı ve fertilizasyon oranı anlamlı olarak yüksek bulunmuştur. Her iki grupta; HCG günü serum östradiol değeri, toplanan toplam oosit sayısı, M2 oosit oranı, Grade 1-2 embriyo sayısı, transfer edilen embriyo sayısı benzer olarak bulunmuştur.Sonuç: Çalışmamızda HH nedeniyle yardımcı üreme tekniği olarak ICSI uygulanan hastalar incelenip KOH tedavisine iyi yanıt verdikleri veyüksek doz gonadotropin tedavileri ile başarılı reprodüktif sonuçlar elde edilebileceği sonucuna varılmıştır.

Kaynakça

  • Matsumoto AM, Snyder PJ, Bhasin S et al. Stimulation of spermatogene- sis with recombinant human follicle-stimulating hormone (follitropin alfa; GONAL-f): long-term treatment in azoospermic men with hypogonadot- ropic hypogonadism. Fertil Steril 2009; 92: 979–990.
  • Ulug U, Shlomo I. The reproductive performance of women with hypo- gonadotropic hypogonadismin an in vitro fertilization and embriyo trans- fer program. Journal of Assisted Reprod and Genetics 2005;22:167-71.
  • Yilmaz S, Ozgu-Erdinc AS. The reproductive outcome of women with hypogonadotropic hypogonadism undergoing in vitro fertilization. Syst Biol Reprod Med. 2015;61:228-32.
  • Shoham Z, Balen A, Patel A, Jacobs HS. Results of ovulation induction using human menopausal gonadotropin or purified follicle-stimulating hormone in hypogonadotropic hypogonadism patients. Fertil Steril 1991; 56: 1048–1053.
  • Balasch J, Miro F, Burzaco I, Casamitjana R, Civico S, Ballesca JL, et al. The role of luteinizing hormone in human follicle development and oocyte fertility: evidence from IVF in a woman with long-standing hypogonadot- rophic hypogonadism and using rFSH. Hum Reprod. 1995; 10: 1678-83.
  • Burgues S. The effectiveness and safety of recombinant human LH to support follicular development induced by recombinant human FSH in WHO group I anovulation: evidence from a multicentre study in Spain. Hum Reprod 2001; 16: 2525–2532.
  • Veeck LL. Atlas of the Human Oocyte and Early Conceptus. Baltimore, Williams&Wilkins,1986.
  • Skalba P, Guz M.Hypogonadotropic hypogonadism in women. Endokry- nol Pol. 2011;62:560-7.
  • Balen AH, Braat DD, West C, Patel A, Jacobs HS. Cumulative concep- tion and live birth rates after the treatment of anovulatory infertility: safety and efficacy of ovulation induction in 200 patients.Hum Reprod. 1994;9:1563-70.
  • Lahoud R, Al-Jefout M, Tyler J, Ryan J, Driscoll G. A relative reduction in mid-follicular LH concentrations during GnRH agonist IVF/ICSI cycles leads to lower live birth rates.Hum Reprod. 2006;21:2645-9.
  • Westergaard LG, Laursen SB, Andersen CY. Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction. Hum Reprod. 2000;15:1003-8.
  • Kumbak B, Kahraman S. Women with hypogonadotropic hypogonadism: cycle characteristics and results of assisted reproductive techniques. Acta Obstet et Gynecol.2006;85:1453-57.
  • Ghaffari F, Arabipoor A.Assisted reproductive technique outcomes in hy- pogonadotropic hypogonadism women. Ann Saudi Med 2013; 33: 235- 240.
  • Lewit N, Shahar K. The low responder hypogonadotropic hypogonadism female patient in IVF: do not give up Fertil Steril. 2000;74:401-2.
  • Liu S, Feng HL. Dose-dependent effects of gonadotropin on oocyte deve- lopmental competence and apoptosis. Reprod Fertil Dev. 2011;23:990- 6.
  • Sönmezer M, Özmen B, Atabekoglu CS, Papuccu EG, Ozkavukcu S, Ber- ker B, Pabuccu R.Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism.J Assist Reprod Genet. 2012 ;29:597-602.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Ahmet Eser Bu kişi benim

Evrim Bostancı Ergen Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 13 Sayı: 4

Kaynak Göster

Vancouver Eser A, Ergen EB. Hipogonadotropik Hipogonadizm Olgularında İnfertilite Tedavisi Sonuçları. JGON. 2016;13(4):160-3.