[Recombinant growth hormone for support of ovarian gonadotropin treatment in a hypophysectomized patient: a...

In a patient, suffering of apituitarism after the surgical removal of a cranyopharyngeoma at the age of 14, was treated with various doses of human urinary gonadotropin preparations for in vitro fertilization and embryo transfer. The first five treatments were performed without the additional administration of recombinant growth hormone, but due to the administration of increasing doses of exogenous gonadotropins a pregnancy was finally achieved leading to the birth of a healthy girl. Later, as the couple desired a second baby, the treatment was repeated using a low dose of gonadotropins in combination with recombinant growth hormone. This combined treatment was immediately successful, leading to the birth of a healthy boy. The present communication offers a complete survey of the existing literature about the use of recombinant growth hormone in support of ovarian stimulation with gonadotropins. The ongoing controversy is caused by the lack of an established methodology for the diagnosis of growth hormone deficiency. Whereas the efficacy of the additional use of recombinant growth hormone in support of ovarian stimulation with gonadotropins is established in patients without any endogenous growth hormone secretion, its use in patients with less defined hormonal disturbances remains controversial.