The retrospective study showed that 87.4%(248/279) ovarian poor responder could be reversed by reduced the dose of GnRH-a or increased initial Gn dose compared with full or a half dose and one third dose of GnRH-a dow...The retrospective study showed that 87.4%(248/279) ovarian poor responder could be reversed by reduced the dose of GnRH-a or increased initial Gn dose compared with full or a half dose and one third dose of GnRH-a down-regulation groups,only 11.1%(31/279) cases taken place ovarian poor responder again in next IVF-ET cycle.The result implied that profound ovarian suppression could be reversed by reduced GnRH-a dose or increased Gn dose in women with ovarian normal function.The dose of GnRH-a may have an impact on the steroidgenesis in IVF-ET cycles.展开更多
Objective: To investigate the cause of hypergonadotropic hypogonadism. Design: Case report and literature review. Setting: University Departments of Pediatric Endocrinology and Obstetrics and Gynecology. Patient(s): A...Objective: To investigate the cause of hypergonadotropic hypogonadism. Design: Case report and literature review. Setting: University Departments of Pediatric Endocrinology and Obstetrics and Gynecology. Patient(s): A 13.5- year- old girl with absent puberty and growth retardation. Intervention(s): None. Main Outcome Measure(s): Detailed biochemical, radiological, and molecular analysis, including pelvic ultrasound, basal steroid hormone analysis in serum and aspirated follicle fluid, serum steroid measurement after ACTH (Synachten) and human chorionic gonadotropin (hCG) stimulation, and molecular analysis of CYP17. Result(s): This girl with hypergonadotropic hypogonadism (LH 65 U/L, FSH 50 U/L) had a 46,XX karyotype, small uterus and enlarged cystic ovaries, and markedly delayed bone age (9 years). Basal (serum, follicular) and stimulated (serum) steroid hormone levels were consistent with isolated 17,20- lyase deficiency whereas relatively normal P and 17- hydroxyprogesterone concentrations were detected together with very low androstenedione, T, and E2 levels. Conclusion(s): Isolated 17,20- lyase deficiency should be considered in the differential diagnosis of hypergonadotropic hypogonadism in 46,XX females, and follicular fluid steroid analysis is a useful adjuvant test. Failure to detect mutations in CYP17 raises the possibility of a novel association of these phenotypes.展开更多
文摘The retrospective study showed that 87.4%(248/279) ovarian poor responder could be reversed by reduced the dose of GnRH-a or increased initial Gn dose compared with full or a half dose and one third dose of GnRH-a down-regulation groups,only 11.1%(31/279) cases taken place ovarian poor responder again in next IVF-ET cycle.The result implied that profound ovarian suppression could be reversed by reduced GnRH-a dose or increased Gn dose in women with ovarian normal function.The dose of GnRH-a may have an impact on the steroidgenesis in IVF-ET cycles.
文摘Objective: To investigate the cause of hypergonadotropic hypogonadism. Design: Case report and literature review. Setting: University Departments of Pediatric Endocrinology and Obstetrics and Gynecology. Patient(s): A 13.5- year- old girl with absent puberty and growth retardation. Intervention(s): None. Main Outcome Measure(s): Detailed biochemical, radiological, and molecular analysis, including pelvic ultrasound, basal steroid hormone analysis in serum and aspirated follicle fluid, serum steroid measurement after ACTH (Synachten) and human chorionic gonadotropin (hCG) stimulation, and molecular analysis of CYP17. Result(s): This girl with hypergonadotropic hypogonadism (LH 65 U/L, FSH 50 U/L) had a 46,XX karyotype, small uterus and enlarged cystic ovaries, and markedly delayed bone age (9 years). Basal (serum, follicular) and stimulated (serum) steroid hormone levels were consistent with isolated 17,20- lyase deficiency whereas relatively normal P and 17- hydroxyprogesterone concentrations were detected together with very low androstenedione, T, and E2 levels. Conclusion(s): Isolated 17,20- lyase deficiency should be considered in the differential diagnosis of hypergonadotropic hypogonadism in 46,XX females, and follicular fluid steroid analysis is a useful adjuvant test. Failure to detect mutations in CYP17 raises the possibility of a novel association of these phenotypes.
