Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn’s disease and premature ovarian insufficiency: a case report

In: Journal of Assisted Reproduction and Genetics · 2012 · vol. 29(9) , pp. 973–977 · doi:10.1007/s10815-012-9816-9 · W2115692435
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AI-generated summary by claude@2026-06+body, 2026-06-12

Estro-progestin treatment was ineffective for corticosteroid-resistant premature ovarian insufficiency, but four years of estro-progestins restored ovarian function and menses.

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This paper reports a case of a 20-year-old woman with Crohn’s disease who developed premature ovarian insufficiency of unknown origin, with amenorrhea and markedly elevated FSH and LH levels, and was treated first with corticosteroids for 10 months and then with estro-progestin therapy for 7 years. Corticosteroids did not restore ovarian volume or normalize gonadotropin levels, whereas estro-progestins led to a prompt reduction of gonadotropins into the normal range after two years and to resumption of ovarian function by four years, supported by normal ovarian volume and ovulatory follicles on ultrasound and by re-establishment of regular menses after treatment discontinuation. The authors’ main limitation is that this is a single case report, so causal effectiveness and generalizability cannot be established. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Purpose To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn’s disease.

Method

Here is reported the case of a 20 years old woman with Cronh’s disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment.

Results

Corticosteroid treatment was ineffective in restoring patients gonadotropin levels as well as ovarian volume, while estro-progestins promoted a prompt reduction in gonadotrophin levels, which returned in the normal range after two years of treatment, as well as restoration of ovarian function, which occurred after four years of estrogens administration, as demonstrated by normal ovarian volume and ovulatory follicles at ultrasound, and by the re-establishment of regular menses after estroprogestin discontinuation.

Conclusions

Long-term suppression of the endogenous gonadotropins using estroprogestins may be suggested as a treatment able to restore ovarian responsiveness even in patients with premature ovarian insufficiency showing highly elevated gonadotropin levels.

References

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Conflict of interest statement and funding The authors declare that they have no conflict of interest. This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Caroppo, E., D’Amato, G. Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn’s disease and premature ovarian insufficiency: a case report. J Assist Reprod Genet 29, 973–977 (2012). https://doi.org/10.1007/s10815-012-9816-9 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10815-012-9816-9

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