- Alieh Tourabizadeh
![Corresponding Author](https://static.jri.ir/images/shapes/email.png) - - Department of Obs. & Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services, Mashad, Iran
- Fatemeh Vahidrodsari
- - Department of Obs. & Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services, Mashad, Iran
Received: 7/1/2005 Accepted: 7/1/2005 - Publisher : Avicenna Research Institute |
|
Related Articles |
|
Other Format |
|
|
|
Abstract
Introduction: Hypogonadotropic amenorrhea is one kind of primary amenorrhea which is caused by a decrease in GnRH secretion and results in infertility. As infertility is an important problem in 10-15% of couples, the present study was undertaken to determine the prevalence of the disease in infertile women and pregnancy rates in response to its treatment. Materials and Methods: This cross-sectional, analytical study included 35 subjects suffering from hypothalamic amenorrhea, pulled from 2150 patients who referred to the infertility center of Montaserieh Hospital in Mashad during 2000-2002. The gathered data included: the patients age, infertility duration, menstrual cycles, history of prior surgeries or illnesses, food regimens and drug history. A gynecologic exam, hormonal assays and sonographic evaluations were carried out. The patients underwent 3 cycles of ovulation induction procedures. A serum -hCG measurement and a vaginal sonography were used to confirm pregnancy. The data were analyzed by SPSS 11. For the descriptive analysis, t-test and logistic regression were used and the significance level was considered 5% (p<0.05 ). results: the patients aged 20-35 and their infertility period varied from 1.5 to 14 years. three of them were excluded from the study because of loss to follow up. the prevalence rate was 1-6%. in all of the patients, the serum fsh and lh levels were <5iu l. serum prolactin levels were 21.7% 34.8 iu l and tsh 1.20.6 iu l. 14 patients out of 32, responded to treatment and became pregnant after three cycles of treatment (43.7%). conclusion: the prevalence rate of infertility due to hypogonadotropic amenorrhea in this study was 0.016. infertility due to hypogonadotropic amenorrhea is a disease that can respond to common ovulation induction treatment schedules quite well and despite the short period of treatment (3 cycles) in this study, 43.7% of the patients became pregnant. it is expected that by increasing the treatment period, better results will follow as it has in studies following 6 cycles of treatment with 83-90.1% success rates.< pan>0.05>
Keywords:
Primary amenorrhea, Hypogonadotropic, Infertility, Gonadotropin, Human menopausal genadotropin, Prolactin, Intrauterin insemination To cite this article:References
- Speroff L., Robert H., Glass. Amenorrhea: Clinical Gynecologic endocrinology and Infertility. 6th Edition. Chapter 11. Lippincott Williams & Wilkins.1999;pp: 422-487.
- Stephani B., Seminara M.D., The GPR 54 Gene as a Regulator of puberty. New England J Med.2003;349 (17):pp:1614.
- Chan J.L. Mantzoros C.S. Role of leptin in energy-deprivation states normal human physiology and clini-cal implications for Hypthelamic amenorrhea. Lancet. 2005;366:(9479):74-85. Review.
- Lewit N., Kol S. The low responder, hypogonadotropic hypogonadism female patient in IVF. Fertil Steril J. 74(2);2000.
- Juan Balasch.Inducing follicular development in anovu-latroy patients and normally ovulating women: Current concepts and role of recombinant gonadotropins, Text book of Assisted Reproductive Treatment, 4th Edition. Chapter 35.2002; 425-440.
- Martin K.A., Hall J., Adams J.M. Comparison of gonadotropin- releasing hormone and exogenous gona-dotropins for induction of evaluation in hypogonado-tropic amenorrhea. J Clin Endocrinol Metab.1999;77 (1):125-9.
- Yoloi N., Kondeh Y. A modifled hMG- GnRH treat-ment for evaluation induction in infertile women with hypothalamic amenorrhea. Endocrinol J.2002;49(2): 159-64.
- Fenichel P., Guedij A., Brucker F., Hypothalamic amenorrhea, Diagnostic and therapeutic value of pulsa-tive administration of gonadotropins. Presse med 17(2), PP:61-4, Jan 1999.
- Nachtigall J., Barrie M., Schwartz L. The application of trans-vaginal ultrasound for evaluation induction and in vitro fertilitzation. Clin Obstet Gynecol.1996; 39:231-247.
- Daniel J., Schust, Mylene W.Infertility Novak's Gyne-cology. 13th Edition. Chapter 27. Lippincott Williams & Wilkins.2002;937-1067.
- Robert L., Barbieri, Kenneth J. The menstrual cycle. Kistner's Gynecology and women's health, 7th Edition. Chapter 3, Mosby.1999;23-58.
- Wendy J., Schiling S., Howard Mc Clamroch. Ameno-rrhea, Novak's Gynecology, 13th Edition. Chapter 24. Lippincott Williams & Wilkins.2002;843-871.
- Steven F., Palter, David L. Reproductive physiology. Novak's Gynecology, 13th Edition.Chapter 7.Lippincott Willams.2002;145-149.