Pregnancy in hypothalamic hypopituitarism.

Pregnancy in hypopituitarism is distinctly rare. The authors have recently seen a 26-year-old white woman who had amenorrhea. Endocrine evaluation demonstrated hypogonadotropic hypogonadism, decreased adrenocorticotropic hormone reserve, and low normal thyroid function. The patient, treated with estrogen replacement for a few cycles and with physiologic doses of hydrocortisone, spontaneously conceived and delivered a premature infant. The circumstantial evidence favored the occurrence of a spontaneous ovulation. The possibility that prior administration of cyclic estrogens and/or physiologic doses of cortisone facilitated gonadotropin release and subsequent ovulation remains unclear but cannot be completely excluded. The onset of premature labor may have been related to hypofunction of the anterior pituitary.