Adult-onset idiopathic hypogonadotropic hypogonadism and pregnancy in a 35-year-old woman: a case report.

Idiopathic hypogonadotropic hypogonadism (IHH) is a rare condition characterized by low gonadotropin production, absent or incomplete puberty and absence of a central nervous system tumor. An adult-onset form of IHH has been found previously only in men.A 35-year-old woman completed puberty and experienced monthly menstrual cycles for 5 years before developing hypogonadotropic secondary amenorrhea that lasted for 17 years. Clinical evaluation failed to explain her prolonged hypogonadotropic amenorrhea, and successful pregnancy was completed following induction of ovulation with exogenous gonadotropin therapy.This case may represent an extreme of the phenotypic spectrum of IHH that has been previously reported to occur in men only. In gonadotropin-sensitive women, pregnancy may be achieved with administration of exogenous human menopausal gonadotropins or with gonadotropin-releasing hormone by infusion pump.