Endocrine Abstracts (2009) 20 P662

Ovulation induction and multicentric follow-up of 21 pregnancies in 14 patients

Laure Villaret1, Olivier Chabre1, Philippe Caron2, Jacques Young3, Nicole Quenard1, Hélène Bry3 & Pascale Hoffmann1

1Grenoble Universitary Hospital, Grenoble, France; 2Toulouse Rangueil Hospital, Toulouse, France; 3Kremlin Bicetre Hospital, Paris, France.

Objective: To determine the outcome of pregnancy in hypopituitary women.

Background: Rare situation, not studied enough: only two previous studies concerning 9 and 19 patients (Overton et Hall).

Design: Multicentric, descriptive, prospective and retrospective study.

Material and methods: Twenty-one pregnancies were registered in 14 hypopituitary women (defined as gonadotropic deficiency associated with at least another pituitary deficiency) with median age 32.5 years (27–41), from 3 French endocrinology centers in the universitary hospitals of Paris (Kremlin-Bicêtre), Toulouse and Grenoble.

Results: The primary outcome was the pregnancy: 93% of patients completed at least one pregnancy. Twenty-one pregnancies were obtained with 17 live births (1 set of twins and 5 miscarriages).

The secondary outcomes were the results of ovulation induction: 95% of ovulation and 56% of pregnancies by stimulation with gonadotrophins; the results of luteal phase support which were better with hCG (associated or not with progesterone), than with progesterone alone; the adaptations of levothyroxine and the other substitutive therapies.

Pregnancy or deliveries’complications, newborns’ health and measurements were also studied. Two complications were noted: oligo-hydramnios and pre-eclampsia, but no acute hypophyseal deficiency. About 62.5% of patients had a physiological delivery.

The 17 newborns were healthy, with median length 50 cm (45–52) and median weight 3234 g (2080–4250), two of them were under the 3th percentile.

Conclusion: Pregnancy can be considered and managed in hypopituitary women, it requires the collaboration of endocrinologists, reproductive physicians and obstetricians for a successful outcome.

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