Document Detail


Severe hypertriglyceridemia and pancreatitis following hormone replacement prior to cryothaw transfer.
MedLine Citation:
PMID:  11958513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A case of acute pancreatitis with severe hypertriglyceridemia occurred following use of intramuscular estradiol valerate during endometrial preparation for cryopreserved embryos. METHODS: A 30-year-old woman with primary infertility and a past history of well-controlled hypothyroidism, underwent endometrial development with intramuscular estradiol valerate in preparation for the transfer of cryopreservred embryos. RESULTS: Initial hospitalization, discontinuation of all estrogens, aggressive intravenous fluid hydration, and initiation of low-fat diet with additional gemfibrozil treatment resulted in complete resolution of all symptoms related to the pancreatitis including the hyperlipidemia. A subsequent cryothaw cycle using oral estradiol resulted in a viable pregnancy with only mild increases in the patient's triglyceride and cholesterol levels noted throughout her 38-week gestation. CONCLUSION(S): Estradiol valerate, a commonly used form of estrogen for endometrial preparation during cryothaw cycles, may cause severe hypertriglyceridemia and acute pancreatitis in certain predisposed individuals. Oral and transdermal estrogens should be the preferred method of endometrial preparation in patients at high risk for lipid metabolism disorders, such as patients with polycystic ovarian syndrome and familial hypertriglyceridemia. These estrogens are more rapidly metabolized and have a shorter half life compared to that of estradiol valerate.
Authors:
Jane Ruman; Steven Brenner; Mark V Sauer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of assisted reproduction and genetics     Volume:  19     ISSN:  1058-0468     ISO Abbreviation:  J. Assist. Reprod. Genet.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-04-17     Completed Date:  2002-10-11     Revised Date:  2008-03-18    
Medline Journal Info:
Nlm Unique ID:  9206495     Medline TA:  J Assist Reprod Genet     Country:  United States    
Other Details:
Languages:  eng     Pagination:  94-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Long Island Jewish Medical Center, New Hyde Park, New York, USA. jruman6129@aol.com
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MeSH Terms
Descriptor/Qualifier:
Cryopreservation
Embryo Transfer*
Endometrium / drug effects,  physiology
Estradiol / adverse effects*,  analogs & derivatives*,  therapeutic use
Female
Humans
Hypertriglyceridemia / chemically induced*,  drug therapy
Infant, Newborn
Infertility, Female / therapy*
Injections, Intramuscular
Male
Pancreatitis / chemically induced*,  drug therapy
Reproductive History
Chemical
Reg. No./Substance:
50-28-2/Estradiol; 979-32-8/estradiol valerate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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