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Induction of Ovulation with the Sole Use of Clomiphene Citrate in Late-Onset 21-Hydroxylase Deficiency

 

作者: Chanchai Laohaprasitiporn,   Robert L. Barbieri,   John Yeh,  

 

期刊: Gynecologic and Obstetric Investigation  (Karger Available online 1996)
卷期: Volume 41, issue 3  

页码: 224-226

 

ISSN:0378-7346

 

年代: 1996

 

DOI:10.1159/000292273

 

出版商: S. Karger AG

 

关键词: Adrenocorticotropin stimulation test;21-Hydroxylase deficiency, late-onset;Polycystic ovary syndrome;Hirsutism;Infertility;Clomiphene citrate

 

数据来源: Karger

 

摘要:

Late-onset 21-hydroxylase deficiency (21-OHD) is a congenital enzymatic defect in the glucocorticoid and mineralocorticoid steroidogenic pathways. The manifestations, including hirsutism and infertility, usually occur at puberty or young adulthood. In infertile, anovulatory women with late-onset 21-OHD, the usual therapy is glucocorticoids for ovulation induction. In this case, we report the sole use of clomiphene citrate to induce ovulation in a patient with late-onset 21-OHD. A hirsute and oligomenorrheic woman was diagnosed as having polycystic ovary syndrome at age 25. Her hirsutism responded to oral contraceptives. At age 31 she was given clomiphene citrate alone for ovulation induction and conceived in her fourth cycle. At age 36, because of increased hirsutism she was diagnosed with late-onset 21-OHD by an ACTH stimulation test. The induction of ovulation in late-onset 21-OHD patients has been with glucocorticoids. Given the success in inducing ovulation with clomiphene citrate alone in this patient with well-documented late-onset 21-OHD, it may be worthwhile to study the sole use of clomiphene citrate for ovulation induction in these patients.

 

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