Successful pregnancy after ovulation induction with human chorionic gonadotropin in a woman with selective luteinising hormone deficiency
Lizandra Moura Paravidine Sasaki 1,2,*, Bruno Ramalho de Carvalho 3, Lizandra Moura Paravidine Sasaki 1,2,*, Bruno Ramalho de Carvalho 3, Adelino Amaral Silva4, Alberto Moreno Zaconeta 1,5, Miriam da SilvaWanderley 5, Luiz Augusto Casulari Roxo da Motta 2,6, and AdrianaLofrano-Porto 6,7
Abstract: Selective LH deficiency has been described in several men, but only in two women who presented normal pubertal developmentAbstract: Selective LH deficiency has been described in several men, but only in two women who presented normal pubertal developmentbut secondary amenorrhoea due to anovulation. Despite its rarity, this condition represents a valuable model for studying the processesregulated by FSH or LH during late folliculogenesis and ovulation in humans. A woman previously diagnosed with selective LH deficiencydue to a homozygous germline splice site mutation in LHB (IVS2þ1G!C mutation) was submitted to an individualised ovarianinduction protocol, first with recombinant LH and then with highly purified urinary hCG. Ovarian follicle growth and ovulation wereachieved, and a healthy baby was born after an uneventful term pregnancy. The treatment described herein demonstrates that the clinicalactions of exogenous LH or hCG in inducing late-stage follicular development in women with deficient LH production or performancemight be interchangeable or inevitable, once FSH-dependent early follicular growth is assured.Key word: LH deficiency / ovulation induction / infertility / hCG induction / LH / FSH / hCG