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Masked high progesterone levels during in vitro fertilization and embryo transfer treatment in a patient with 21‐hydroxylase deficiency: A case report
Author(s) -
Mizusawa Yuri,
Katayama Kazuaki,
Matsumoto Yukiko,
Kokeguchi Shoji,
Shiotani Masahide
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14719
Subject(s) - in vitro fertilisation , medicine , congenital adrenal hyperplasia , embryo transfer , endocrinology , infertility , ovulation , endometrium , folliculogenesis , fertility , ovulation induction , reproductive technology , andrology , embryo , pregnancy , biology , hormone , embryogenesis , population , genetics , environmental health , microbiology and biotechnology
The most common form of congenital adrenal hyperplasia is 21‐hydroxylase deficiency (21OHD). Women with 21OHD have reduced fertility because of excessive production of adrenal androgen and progesterone, which can inhibit folliculogenesis, disturb the normal gonadotropin secretion pattern and development of the endometrium, and affect endometrial receptivity. Here, we report on an infertile woman with 21OHD who initially showed normal progesterone levels and spontaneous ovulation with the treatment by an endocrinologist. However, in vitro fertilization and embryo transfer repeatedly failed because of a gradual elevation in progesterone, which was masked by fertility treatment. The case underlines that close coordination is required between the endocrinologist and reproductive specialist for the total treatment for woman with 21OHD.