Isolated adrenocorticotropin deficiency presenting as primary infertility

S. L. Atkin, E. A. Masson, M. C. White

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A 31 year old female presented with primary infertility and gave a two year history of amenorrhea without symptoms or signs of endocrine dysfunction. Examination was normal and investigation showed low oestradiol and progesterone levels with decreased LH pulsatility. The cortisol responses were impaired following hypoglycaemic stress and a short synacthen test, but the cortisol response to a prolonged synacthen test was normal. An inadequate ACTH response to CRF testing confirmed the diagnosis of isolated ACTH deficiency. Hydrocortisone therapy was followed by an ovulatory menstrual cycle. Amenorrhea again ensued following the reduction of the steroid dose and normal menses resumed on normal steroid replacement therapy. Six hourly gonadotrophin pulsatility showed a significant increase in both pulse amplitude and mean LH and FSH levels following steroid treatment. Isolated ACTH deficiency is a rare but treatable cause of hypogonadism and infertility, and this case gives further insight on the role of cortisol on the hypothalamo-pituitary gonadal axis.

Original languageEnglish
Pages (from-to)456-459
Number of pages4
JournalJournal of endocrinological investigation
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 1995

Keywords

  • Isolated ACTH deficiency
  • amenorrhea
  • primary infertility

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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