Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, Harvard Medical School, 100 Blossom street, Cox building, Suite 140, Boston, MA, 02114, USA.
Department of Endocrinology and Center for Translational Endocrinology (CETREN), School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Pituitary. 2020 Oct;23(5):498-506. doi: 10.1007/s11102-020-01050-2.
Pegvisomant (PEG) is an effective therapy for acromegaly. Its safety in women seeking fertility and during pregnancy has been scarcely reported.
A retrospective chart review was performed in three patients with acromegaly who received PEG while attempting to conceive. Published studies regarding this topic were analyzed.
Four pregnancies in three women with acromegaly are reported. In the first patient, PEG was withdrawn three days before embryo transfer in her first pregnancy and 2 weeks prior to transfer in the second pregnancy. Each transfer resulted in a healthy full-term newborn. In the second and third patients, PEG was withdrawn at diagnosis of pregnancy. No fetal complications occurred during gestations which resulted in three full-term newborns (one single and one twin pregnancy). No abnormalities in development were found in the five live births described. Few cases of pregnancies in women exposed to PEG have been reported and therefore safety cannot be clearly established. In this series, all four pregnancies had good outcomes with discontinuation of the drug before or at first knowledge of conception. A review of the literature reveals no evident drug-related abnormalities in the offspring, even in the few women with continued use of PEG throughout pregnancy.
Preconception therapy with PEG resulted in successful fertility outcomes. Although few cases have been reported, these four pregnancies with PEG use prior to or at the time of conception were not associated with significant maternal or fetal complications. More studies are needed to establish the safety of PEG preconception.
培维索孟（PEG）是治疗肢端肥大症的有效疗法。关于其在寻求生育的女性及妊娠期间的安全性的报道甚少。
对 3 例接受 PEG 治疗的肢端肥大症女性进行了回顾性病历分析，这些患者在尝试妊娠的同时接受了 PEG 治疗。分析了该主题的已发表研究。
报告了 3 例肢端肥大症女性的 4 例妊娠。在第 1 例患者中，她的第 1 次妊娠胚胎移植前三天和第 2 次妊娠前 2 周停用了 PEG。每次移植都成功分娩了健康的足月新生儿。第 2 例和第 3 例患者在妊娠诊断时停用了 PEG。在妊娠期间，没有发生胎儿并发症，导致 3 例足月新生儿（1 例单胎和 1 例双胎妊娠）出生。所描述的 5 例活产儿中未发现发育异常。已报道的接受 PEG 暴露的女性妊娠病例较少，因此无法明确其安全性。在本系列中，所有 4 例妊娠均在停药前或首次发现妊娠时停药，结局良好。文献复习显示，即使少数女性在整个妊娠期间继续使用 PEG，也未发现与药物相关的后代明显异常。需要更多的研究来确定 PEG 孕前治疗的安全性。
PEG 的孕前治疗可获得成功的生育结局。尽管已报道的病例较少，但这 4 例在妊娠前或妊娠时使用 PEG 的妊娠并未导致明显的母婴并发症。需要更多的研究来确定 PEG 孕前治疗的安全性。
