Conception and pregnancy outcome in a patient with 11-bp deletion of the steroidogenic acute regulatory protein gene

Fertil Steril. 2009 Mar;91(3):934.e15-8. doi: 10.1016/j.fertnstert.2008.07.1770. Epub 2008 Sep 30.

Abstract

Objective: To report the pregnancy outcome of a patient with congenital lipoid adrenal hyperplasia (CLAH) due to an 11-bp deletion of the steroidogenic acute regulatory protein (StAR) gene.

Design: Case report.

Setting: University-based pediatric endocrinology unit and private IVF clinic.

Patient(s): A 24-year-old woman homozygous for a StAR gene deletion, married to a man heterozygous for the same molecular defect.

Intervention(s): Ovarian stimulation, oocyte retrieval followed by IVF, blastomere biopsy, preimplantation genetic diagnosis, and additional estrogen support until placental function initiation.

Main outcome measure(s): Normal pregnancy outcome and delivery of a healthy newborn.

Result(s): A female patient with CLAH gave birth to a normal newborn after IVF and preimplantation genetic diagnosis.

Conclusion(s): Pregnancy is feasible in patients with StAR gene mutations, provided that extra estrogens are offered until placental function ensues.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Hyperplasia, Congenital / complications
  • Adrenal Hyperplasia, Congenital / diagnosis
  • Adrenal Hyperplasia, Congenital / genetics*
  • Embryo Implantation*
  • Estrogens / therapeutic use
  • Female
  • Fertility Agents, Female / therapeutic use
  • Fertilization in Vitro
  • Heterozygote
  • Homozygote
  • Humans
  • Infertility, Female / genetics
  • Infertility, Female / therapy*
  • Live Birth*
  • Male
  • Oocyte Retrieval
  • Ovulation Induction
  • Phosphoproteins / genetics*
  • Pregnancy
  • Preimplantation Diagnosis*
  • Reproductive Techniques, Assisted*
  • Sequence Deletion*
  • Young Adult

Substances

  • Estrogens
  • Fertility Agents, Female
  • Phosphoproteins
  • steroidogenic acute regulatory protein