Question

esy A. i as a E- an Normal No Spaci... Heading 1 Heading z Styles Paragraph 11. Carrie and Bobhave been attemptingto conceive forthe last year. They have consulted a fertility specialist, who conductedlab and diagnostic tests. The lab results are as follows: Carrie LH (serum) Follicular 15 mlU/mL Mid-cycle 80 mU/mL Progesterone (serum) Before ovulation (follicular) 0.5 ng/mL. After ovulation (luteal) 4 ng/mL (within normal range) FSH (serum) Pre- and post-ovulation 12 mlU/mL Mid-cycle 30 mU/mL

Answer 1

I shall answer the questions in the first part of the case :

1. The reports indicate the following :

FSH levels are high, in all phases of menstrual cycle. This indicates primary hypogonadism, either congenital or acquired. Most commonly it indicates ovarian failure if even LH is raised.

The LH and progesterone levels are within normal range. So it is most likely gonadotroph adenoma which is a pituitary gland abnormality. Other hormones secreted by pituitary should be tested. These include prolactin, ACTH and TSH.

A MRI scan of the pituitary should be obtained to confirm the diagnosis of adenoma.