Browsing by Author "Zacharin, Margaret"

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    Fertility outcomes in male adults with congenital hypogonadotropic hypogonadism treated during puberty with human chorionic gonadotropin and recombinant follicle stimulating hormone
    (2024) Grob Lunecke, Francisca; Keshwani, Rachna; Angley, Eleanor; Zacharin, Margaret
    Aim: Hormone replacement therapy with testosterone for pubertal induction in boys with congenital hypogonadotropic hypogonadism (CHH) achieves virilization but not spermatogenesis. By contrast, human chorionic gonadotropin (hCG) and recombinant follicle stimulating hormone (rFSH) provides both virilization and spermatogenesis. Fertility outcomes of boys treated with recombinant therapy during adolescence have been infrequently described. We report fertility induction and pregnancy outcomes in CHH patients treated with recombinant gonadotropins during puberty. Methods: Data of six subjects with CHH (n = 3 Kallmann syndrome & n = 3 Isolated hypogonadotropic hypogonadism) treated with hCG and FSH for pubertal induction were reviewed. Of these, five underwent subsequent fertility induction while one desired fertility at the end of pubertal induction. Results: Partners of all subjects achieved pregnancies using hCG and rFSH, all with full term live births. All infants were clinically normal. Conclusion: This study provides early evidence of proof of concept of use of gonadotropin induction of puberty being beneficial in subsequent fertility outcome.
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    Neurodevelopmental follow-up of children born to mothers with Graves’ disease and neonatal hyperthyroidism
    (2024) Grob Lunecke, Francisca Andrea; Brown, Amy; Zacharin, Margaret
    Introduction: Neonatal hyperthyroidism, often caused by maternal Graves' disease (GD), carries potential neurodevelopmental risks for children. Excessive thyroid hormones during fetal development are linked to neurological issues like ADHD and epilepsy. However, the impact of transient neonatal hyperthyroidism is not well understood. Methods: In a retrospective study at the Royal Children's Hospital in Melbourne, 21 neonates with hyperthyroidism from mothers with GD were examined. Of these, the parents of 10 children consented to participate; thus, questionnaires assessing executive functions, behavior, and social communication were completed. The outcomes were compared to those of control subjects recruited from the community using standardized tools (BRIEF, SDQ, SCQ). The results were analyzed against socio-demographic factors, maternal, and neonatal health. Results: No significant demographic or clinical differences were found between study participants (n=10) and nonparticipants (n=11). Participants, compared to controls, showed similar family demographics but a higher proportion of control parents had university-level education (p=0.003). Patients displayed more social (SCQ scores: 12.1±2.5 vs. 6±1.07, p=0.008) and behavioral difficulties (SDQ scores: 10.2±2.17 vs. 6.14±1.03, p=0.03), with increased executive function challenges (BRIEF scores indicating problem-solving and self-regulation difficulties). Significant effects of family living situation and partner education level on neurodevelopmental measures were noted, underscoring the influence of socio-demographic factors. Conclusions: These findings suggest neonatal hyperthyroidism might lead to subtle neurodevelopmental variations, with socio-economic elements and family dynamics possibly intensifying these effects. While most children didn't show severe impairments, early detection and intervention are recommended. The research emphasizes the necessity for inclusive care approaches that consider socio-economic factors for children affected by neonatal hyperthyroidism