Pulsatile gonadotropin-releasing hormone therapy induces spermatogenesis in pituitary stalk interruption syndrome:A case report and review of the literature  

作　　者：Jin-Long Xie Hai-Ying Zhu Yang Dong Ping-Ping Sun Dan-Dan Qi Su-Xian Luan Yan Zhang Hua-Gang Ma 

机构地区：[1]The Reproductive Medicine Centre,Weifang People's Hospital,Weifang 261000,Shandong Province,China [2]Department of Radiology,Weifang People's Hospital,Weifang 261000,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2024年第20期4348-4356,共9页世界临床病例杂志

基　　金：Weifang Fundamental Research Projects,No.WFWSJK-2023-052.

摘　　要：BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.

关 键 词：Pituitary stalk interruption syndrome Hypogonadotropic hypogonadism SPERMATOGENESIS Pulsatile gonadotropinreleasing hormone therapy Case report 

分 类 号：R725.9[医药卫生—儿科]