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Impact of hypogonadotropic hypogonadism on ovarian reserve and response

  • Reproductive Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the hormonal profile, antral follicle count (AFC) and ovarian response of patients with hypogonadotropic hypogonadism (HH).

Design

Observational retrospective cohort including infertile women with HH undergoing assisted reproductive treatment (ART).

Setting

University-affiliated infertility center.

Patient(s)

Thirty-three women with HH who underwent ART between January 2007 and September 2018. The control group comprised 66 age-matched counterparts with tubal or male factor infertility. The patients with an abnormal karyotype, and those presenting primary or secondary amenorrhea due to other causes, were cautiously excluded.

Intervention(s)

None.

Main outcome measure(s)

The primary outcome was serum levels of anti-Müllerian hormone (AMH) and AFC. We also investigated whether HH impacts ovarian response and reproductive outcomes.

Result(s)

Although AFC was similar between groups, HH patients showed significantly higher AMH levels (4.6 ± 2.7 ng/mL vs. 3.0 ± 1.9, p = 0.010) and lower basal FSH and LH. While the HH group needed longer stimulation [13 days (11–26) vs. 10 (7–14), p < 0.001] and higher gonadotropin doses [2700 IU (825–6300) vs. 2100 (425–5000), p = 0.038 ], no significant differences were detected in either the number or maturity of retrieved oocytes, or in the fertilization rate, number of embryos transferred, implantation rate, clinical pregnancy rate and live birth rate per cycle.

Conclusion(s)

HH patients present higher AMH levels, but similar AFC. Despite requiring longer stimulation and higher gonadotropin doses, ovarian response and reproductive outcomes seem unaffected.

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Acknowledgments

The results of this study were presented in part at the 32nd National Congress of the Spanish Fertility Society held in Madrid, Spain, 16–18 May 2018.

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Author notes

  1. Gustavo N Cecchino and Guillermo M Canillas contributed equally to this work.

Authors and Affiliations

  1. Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros 632, Vila Clementino, São Paulo, SP, 04024-002, Brazil

    Gustavo N. Cecchino

  2. Department of Gynecology and Obstetrics, Rey Juan Carlos University, Avenida de Atenas s/n, Alcorcón, 28922, Madrid, Spain

    Gustavo N. Cecchino & Juan A. García-Velasco

  3. IVIRMA Global Madrid, Avenida del Talgo 68, Aravaca, 28023, Madrid, Spain

    Gustavo N. Cecchino, Guillermo M. Canillas, María Cruz & Juan A. García-Velasco

Authors
  1. Gustavo N. Cecchino
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  2. Guillermo M. Canillas
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  3. María Cruz
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  4. Juan A. García-Velasco
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Contributions

JAGV designed the study. MC performed data extraction. GNC was responsible for the statistical analysis. GNC and GMC performed the exploratory analysis, assessed data quality, and wrote the first manuscript draft. JAGV and MC critically revised the manuscript. All the authors approved the final version of the manuscript.

Corresponding author

Correspondence to Gustavo N. Cecchino.

Ethics declarations

The Ethics Committee of the University Hospital Puerta de Hierro Majadahonda approved the study protocol (Identification Code 1802-MAD-014-JG; February 26, 2018), which also complied with the Spanish law on assisted reproductive technologies. The need for informed consent was waived owing to the retrospective design of this study, as stated in the Institutional Review Board approval letter.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cecchino, G.N., Canillas, G.M., Cruz, M. et al. Impact of hypogonadotropic hypogonadism on ovarian reserve and response. J Assist Reprod Genet 36, 2379–2384 (2019). https://doi.org/10.1007/s10815-019-01587-7

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  • DOI: https://doi.org/10.1007/s10815-019-01587-7

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