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Endocrine Abstracts (2021) 73 OC4.4 | DOI: 10.1530/endoabs.73.OC4.4


University College London Hospitals, Reproductive Medicine Unit, London, United Kingdom


Previous studies have documented poor fertility results in women with hypopituitarism (HP) both in terms of pregnancy rates and outcomes. We aimed to assess ovulation induction (OI) and pregnancy outcomes in women with HP compared to women with hypogonadotrophic hypogonadism (HH) treated at University College London Hospitals.


A retrospective study.


39 women with HP and 57 women with HH underwent 143 and 266 cycles of OI respectively (median age at cycle 33.5 years [interquartile range (IQR) 31.4–37.0] vs 34.3 years [IQR 32.3–36.6] respectively, P = 0.35).


OI was carried out by using human menopausal gonadotropin (hMG) according to a standard protocol and a 10, 000 IU human chorionic gonadotropin trigger. Baseline serum oestradiol, follicle stimulating hormone, luteinizing hormone, prolactin, thyroid functions tests and insulin-like growth factor-1 were measured together with a uterine scan. Ovulation was confirmed by a mid-luteal phase progesterone of >30 nmol/l or ultrasound evidence of corpus luteum. Clinical pregnancy was defined by the presence of at least one heartbeat on an ultrasound scan.


Ovulation rates were similar between women with HP and HH. Although pregnancy and live birth rates per cycle were greater in women with HP compared to women with HH (28.7% vs 16.2%, P = 0.003 and 17.0% vs 9.4%, P = 0.025 respectively), pregnancy and live birth rates per patient were similar (66.7% vs 50.9%, P = 0.125 and 48.6% vs 37.5%, P = 0.286 respectively). Foetal loss per pregnancy was not different between women HP and HH (29.3% vs 39.5%, P = 0.323 respectively), with a similar proportion of multiple pregnancies per live births between the 2 groups of women (HP 8.3% vs HH 20.0%, P = 0.243). There were no major complications in most of the deliveries. Median number of cycles to pregnancy in women with HH was 9 (Standard Error [SE] 0.0) vs 6 cycles (SE 0.8) in women with HP (Log Rank: P = 0.001).


Encouraging ovulation and pregnancy rates can be obtained in women with HP using hMG. A smaller uterine size and lack of size normalisation following standard oestrogen replacement therapy may in part explain the greater miscarriage rate compared to the general population in these women. Management in a multidisciplinary team is advised.

Volume 73

European Congress of Endocrinology 2021

22 May 2021 - 26 May 2021

European Society of Endocrinology 

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