Abstract:
OBJECTIVE:To describe the case of a Japanese woman with combined 17alpha-hydroxylase/17,20-lyase deficiency (congenital adrenal hyperplasia type V) and to discuss possible therapeutic procedures in such patients. DESIGN:Case report. SETTING:University hospital. PATIENT(S):A 26-year-old woman with secondary amenorrhea and primary sterility. INTERVENTION(S):Nucleotide sequencing of the P45017alpha gene (CYP17), induction of endometrial maturation with steroid hormone replacement, and ovulation induction with gonadotropin. MAIN OUTCOME MEASURE(S):Nucleotide sequence of CYP17, endometrial thickness and follicle diameter measured by transvaginal ultrasonography, and histologic evaluation of the endometrium. RESULT(S):Two different mutations were detected on CYP17: One was a deletion of the phenylalanine codon (TTC) at either amino acid 53 or 54 in exon 1, and the other was a missense mutation with the substitution of histidine (CAC) by leucine (CTC) at position 373 in exon 6. Repeated histologic evaluations performed during treatment with P consistently revealed an unripe endometrium with glands of the early secretory phase and markedly scanty stroma. Ultrasound examination revealed follicular growth and ovulation after gonadotropin administration, but insufficient thickness of the endometrium. CONCLUSION(S):Ovulation induction was possible in this patient with 17alpha-hydroxylase/17,20-lyase deficiency, but the endometrial response to steroid hormone replacement was extremely poor.
journal_name
Fertil Steriljournal_title
Fertility and sterilityauthors
Matsuzaki S,Yanase T,Murakami T,Uehara S,Nawata H,Yajima Adoi
10.1016/s0015-0282(00)00500-8keywords:
subject
Has Abstractpub_date
2000-06-01 00:00:00pages
1183-6issue
6eissn
0015-0282issn
1556-5653pii
S0015028200005008journal_volume
73pub_type
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journal_title:Fertility and sterility
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abstract:OBJECTIVE:To review the literature to determine the magnitude of the effect of 150 micrograms desogestrel-30 micrograms ethinyl E2, an oral contraceptive (OC) formulation, on plasma lipid concentrations in healthy women using meta-analysis techniques. DATA SOURCES:All English-language published reports (1981 to 1991) ...
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journal_title:Fertility and sterility
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journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-11-01 00:00:00
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更新日期:2006-07-01 00:00:00
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pub_type: 评论,杂志文章
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pub_type: 临床试验,杂志文章
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abstract:OBJECTIVE:To consider the arguments for and against funding for in vitro fertilization (IVF) and to explore potential avenues for policy change. DESIGN:Narrative literature review, policy analysis. SETTING:University Department of Obstetrics and Gynecology. PATIENT(S):Sub-fertile women and men. INTERVENTION(S):Fert...
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