PDF(Pubmed)
Abstract：
UNASSIGNED: Idiopathic hypogonadotropic hypogonadism (IHH) is a prevalent congenital genetic disorder with multiple inheritance patterns. IHH can manifest as normal hypogonadotrophic sexual hypofunction (nIHH) or with an abnormal sense of smell, known as Kallmann. It primarily affects the production and effectiveness of gonadotropin-releasing-hormone (GnRh), leading to reduced follicle-stimulating hormone and luteinizing hormone levels. This results in infertility and underdeveloped secondary sexual characteristics.
UNASSIGNED: A 29-year-old female presented with infertility.
UNASSIGNED: IHH diagnosis was confirmed through magnetic resonance (MR) scan, endocrine tests, physical examination, and B ultrasonic inspection. Additionally, genetic studies, including chromosome analysis, were conducted for the patient. The results confirmed no genetic abnormalities or concerns.
UNASSIGNED: The patient underwent multiple ovulation induction programs.
UNASSIGNED: After several ovulation induction cycles, the patient conceived and delivered a live baby.
UNASSIGNED: For IHH patients, a tailored human menopausal gonadotropin (HMG) dose is recommended. High-dose HMG can benefit those with poor follicular response. The addition of letrozole (5-7.5mg) may enhance follicular response during stimulation. Our approach, which emphasizes the combined use of high-dose HMG, letrozole, and the adjustment of FSH and LH ratios, offers a unique perspective compared to traditional treatments. If HMG treatment is ineffective, alternative ovulation induction methods, such as r-fsh combined with r-lh or HMG combined with rLH, can be considered. Adjusting the FSH and LH ratio and varying rFSH and rLH additions might help achieve dominant follicles and live birth in resistant cases. This case report underscores the potential benefits of our regimen, suggesting its consideration for future research and clinical applications.
UNASSIGNED: A 29-year-old female presented with infertility.
UNASSIGNED: IHH diagnosis was confirmed through magnetic resonance (MR) scan, endocrine tests, physical examination, and B ultrasonic inspection. Additionally, genetic studies, including chromosome analysis, were conducted for the patient. The results confirmed no genetic abnormalities or concerns.
UNASSIGNED: The patient underwent multiple ovulation induction programs.
UNASSIGNED: After several ovulation induction cycles, the patient conceived and delivered a live baby.
UNASSIGNED: For IHH patients, a tailored human menopausal gonadotropin (HMG) dose is recommended. High-dose HMG can benefit those with poor follicular response. The addition of letrozole (5-7.5mg) may enhance follicular response during stimulation. Our approach, which emphasizes the combined use of high-dose HMG, letrozole, and the adjustment of FSH and LH ratios, offers a unique perspective compared to traditional treatments. If HMG treatment is ineffective, alternative ovulation induction methods, such as r-fsh combined with r-lh or HMG combined with rLH, can be considered. Adjusting the FSH and LH ratio and varying rFSH and rLH additions might help achieve dominant follicles and live birth in resistant cases. This case report underscores the potential benefits of our regimen, suggesting its consideration for future research and clinical applications.
摘要：
■特发性低促性腺激素性性腺功能减退症（IHH）是一种常见的先天性遗传障碍，具有多种遗传模式。IHH可表现为正常的低促性腺激素性性功能减退（nIHH）或嗅觉异常，被称为Kallmann.它主要影响促性腺激素释放激素（GnRh）的产生和有效性，导致卵泡刺激素和黄体生成素水平降低。这导致不育和不发达的第二性征。
■一名29岁女性出现不孕症。
■通过磁共振（MR）扫描确认了IHH诊断，内分泌测试,体检,和B超检查。此外,基因研究,包括染色体分析,为患者进行。结果证实没有遗传异常或担忧。
■患者接受了多次排卵诱导计划。
■经过几个排卵诱导周期，病人怀孕并分娩了一个活婴儿。
■对于IHH患者，推荐定制的人类更年期促性腺激素（HMG）剂量。高剂量HMG可以使卵泡反应不良的患者受益。添加来曲唑(5-7.5mg)可以增强刺激期间的卵泡反应。我们的方法,强调高剂量HMG的联合使用，来曲唑,以及FSH和LH比率的调整，与传统治疗相比，提供了独特的视角。如果HMG治疗无效，替代排卵诱导方法，例如r-fsh与r-lh组合或HMG与rLH组合，可以考虑。调整FSH和LH比例以及不同的rFSH和rLH添加量可能有助于在耐药病例中实现优势卵泡和活产。此病例报告强调了我们的治疗方案的潜在益处，提出了对未来研究和临床应用的考虑。
■一名29岁女性出现不孕症。
■通过磁共振（MR）扫描确认了IHH诊断，内分泌测试,体检,和B超检查。此外,基因研究,包括染色体分析,为患者进行。结果证实没有遗传异常或担忧。
■患者接受了多次排卵诱导计划。
■经过几个排卵诱导周期，病人怀孕并分娩了一个活婴儿。
■对于IHH患者，推荐定制的人类更年期促性腺激素（HMG）剂量。高剂量HMG可以使卵泡反应不良的患者受益。添加来曲唑(5-7.5mg)可以增强刺激期间的卵泡反应。我们的方法,强调高剂量HMG的联合使用，来曲唑,以及FSH和LH比率的调整，与传统治疗相比，提供了独特的视角。如果HMG治疗无效，替代排卵诱导方法，例如r-fsh与r-lh组合或HMG与rLH组合，可以考虑。调整FSH和LH比例以及不同的rFSH和rLH添加量可能有助于在耐药病例中实现优势卵泡和活产。此病例报告强调了我们的治疗方案的潜在益处，提出了对未来研究和临床应用的考虑。
