Fertility and fragrance: another cause of Kallmann syndrome

Endocrine factors associated with infertility in women: an updated review

INTRODUCTION

Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women.

AREAS COVERED

A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders. The diagnostic approach was outlined, emphasizing the necessity of hormonal studies and ovarian response assessments. Additionally, the treatment plan was presented, commencing with non-pharmacological interventions, encompassing the adoption of a Mediterranean diet, vitamin supplementation, moderate exercise, and maintaining a healthy weight. Subsequently, pharmacological treatment was discussed, focusing on the management of associated endocrine disorders and ovulatory dysfunction.

EXPERT OPINION

This comprehensive review highlights the impact of endocrine disorders on fertility in women, providing diagnostic and therapeutic algorithms. Despite remaining knowledge gaps that hinder more effective treatments, ongoing research and advancements show promise for improved fertility success rates within the next five years. Enhanced comprehension of the pathophysiology behind endocrine causes and the progress in genetic research will facilitate the delivery of personalized treatments, thus enhancing fertility rates.

A rare disease of Kallmann syndrome: A case report

Kallmann syndrome (KS) is a rare genetic disorder that refers to the association between hypogonadotropic hypogonadism and anosmia or hyposmia due to abnormal migration of olfactory axons and gonadotropin-releasing hormone-producing neurons. Here, we present a case of a 40-year-old man who presented with psychological problems (emotional disturbance) as the chief complaint. Physical examination revealed gynecomastia, absence of facial and axillary hair, and sparse pubic hair, micropenis, undescended right testicle, low libido and lack of sexual function. A related finding is anosmia, a high-pitched voice. Hormonal analysis revealed hypogonadotropic hypogonadism profile, and chromosomal examination revealed a normal male karyotype. Abdominal ultrasound showed normal organs, and scrotal ultrasound showed an undescended right testicle (UDT) and small testes. Brain MRI revealed pituitary gland hypoplasia and olfactory bulb agenesis. These findings are characteristic of KS. He underwent orchidopexy dextra. He is now on a regular follow-up. Hormone replacement therapy is planned. Thus, besides medical treatments, psychological care is an integral component of the treatment strategy for this patient.