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A successful live birth from a 17 α-hydroxylase/17,20-lyase deficiency mother by the in vitro fertilization frozen-thawed embryo transfer

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单位: [1]Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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关键词: 17 alpha-hydroxylase/17 20-lyase deficiency congenital adrenal hyperplasia infertility luteal-phase ovarian stimulation pregnancy complications

摘要:
A 24-year-old Chinese female was manifested by the primary infertility and primary amenorrhea, sexual infantilism, recurrent ovarian cysts and hypertension. Genetic analysis diagnosed this patient as 17 alpha-hydroxylase and 17,20-lyase deficiency (17OHD) as she harbours a homozygous c.707T>G mutation in exon 4 of the CYP17A1 gene, which resulted in a substitution of amino acid valine (V) at position 236 to glycine (G) (V236G). In vitro fertilization (IVF) frozen-thawed embryo transfer under luteal-phase ovarian stimulation protocol was then recommended due to the complexity of the steroidogenic disorder caused by 17OHD. Other treatment included glucocorticoid administration to suppress the elevation of progesterone, endometrial preparation with exogenous steroids and subsequent transfer of frozen-thawed embryos. At the 29th week of pregnancy, a caesarean section was performed due to the diagnosis of haemolysis elevated liver enzymes low platelets (HELLP) syndrome. A live normal female newborn was delivered with Apgar score 1/4 and 780 g in body weight. The new-born was discharged in a good condition 7 weeks after delivery. This outcome supports that 17OHD females still could have a successful pregnancy and delivery with adequate hormonal control and endometrial preparation. Luteal-phase ovarian stimulation is proved to be a convenient and time-saving approach to retrieve oocytes for these patients. However, 17OHD should be closely monitored when females are pregnant for better management of pregnancy complications and neonatal care.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验
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出版当年[2015]版:
Q4 MEDICINE, RESEARCH & EXPERIMENTAL
最新[2023]版:
Q4 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者单位: [1]Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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通讯机构: [1]Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China [*1]Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, Hubei, People’s Republic of China.
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