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Question
hello
i am anne from uk. we have familial panhypopituitarism. my daughter is on gh, thyroxine and steroids, and we are expected to have primary amenorrhoea. she is 8 now. my question is if it is possible for her to have a normal sized uterus and to get pregnant in future if we induce puberty artificially with oestrogens and progesterone? what are the fertility outcomes in congenital hypopituitarism?and is there any role of adult growth hormone replacement therapy in ovulation induction and fertility.

Answer
Hello Anne from the U.K.,

If the reproductive organs developed correctly, then your daughter can have a normal hormonal life.  All the reproductive hormones can be replaced, like the GH, Thyroid and corticoids, and they should be so that your daughters can go through normal physical development as well.  She will need to take FSH and LH which can be found together in medications such as Pergonal, Menopur or Repronex, or she can get Estrogen and Progesterone directly.  These can then be used to put her through puberty, give her cycles and, in the future, allow her to achieve pregnancy.  It is somewhat complex but if taken care of by a competent Endocrinologist, she can be completely normal.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at info@montereybayivf.com.  This service will allow you to have your own personal on-demand infertility expert

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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