Kallmann syndrome, a congenital disorder of idiopathic hypogonadotropic hypogonadism associated with anosmia, results in infertility because of anovulation. Assisted reproductive technology (ART) is considered when optimal ovulation induction therapy is difficult or when several cycles of ovulation induction therapy do not result in pregnancy. However, evidence is lacking regarding the optimal ART treatment for Kallmann syndrome. We report the case of a 33-year-old woman who successfully achieved pregnancy and delivery after ART treatment. At 29 years old, she was diagnosed with Kallmann syndrome due to hypothalamic amenorrhea and anosmia. At 33 years old, she revisited the hospital, desiring a child after one year of infertility. Due to anovulation, she was treated with gonadotropin therapy, but controlling follicular development was difficult, and thus ART treatment was initiated. The controlled ovarian stimulation (COS) protocol for ART treatment employed gonadotropins, recombinant follicular stimulating hormone/human menopausal gonadotropin plus human chorionic gonadotropin, to promote follicular growth. Four oocytes were retrieved, and two cleaved embryos were vitrified and cryopreserved. After vitrified-warmed embryo transfer of a morula stage embryo in a hormone replacement cycle, pregnancy was achieved but resulted in a miscarriage. A second oocyte retrieval was performed under the same COS; four oocytes were retrieved, and two cleaved embryos were vitrified and cryopreserved. Further, a pregnancy was achieved through the vitrified warmed embryo transfer. At 40 weeks and 6 days of gestation, a baby boy weighing 3,344 g with an Apgar score of 7/8 was delivered vaginally. The mother’s postpartum course and neonate were free from adverse events. For women with Kallmann syndrome, ART treatment and selective embryo cryopreservation may be a reasonable and safe option.
Abstract/References
Successful pregnancy and delivery after a vitrified-warmed embryo transfer in a woman with Kallmann syndrome: A case report and literature review
Aya Shiraiwa, Toshifumi Takahashi, Chihiro Okoshi, Marina Wada, Kuniaki Ota, Ryota Suganuma, Masatoshi Jimbo, Shu Soeda, Takafumi Watanabe, Hiromi Yoshida-Komiya, Keiya Fujimori
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Aya Shiraiwa
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Toshifumi Takahashi
Fukushima Medical Center for Children and Women, Fukushima Medical University
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Chihiro Okoshi
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Marina Wada
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Kuniaki Ota
Fukushima Medical Center for Children and Women, Fukushima Medical University
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Ryota Suganuma
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Masatoshi Jimbo
Fukushima Medical Center for Children and Women, Fukushima Medical University
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Shu Soeda
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Takafumi Watanabe
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Hiromi Yoshida-Komiya
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
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Keiya Fujimori
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine
Abstract
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