{
    "abstract": "Acute porphyrias are rare disorders of the heme biosynthetic pathway and present with acute neurovisceral symptoms that can be induced by hormonal changes and medications. Women are far more likely to present with clinical symptoms than men, particularly during parts of their lifetime with changes in the level of female sex hormones such as ovulation, menstruation, and pregnancy. Treatment of ovulatory dysfunction and controlled ovarian hyperstimulation require the administration of hormones, which are considered porphyrinogenic. Women with acute hepatic porphyria have therefore been considered unsuitable for such treatments in the past.\nWe report on nine women with acute hepatic porphyria who underwent in vitro fertilization (IVF), preceded by ovarian stimulation. Their mean age at the start of IVF was 33.2\u00a0years (range 27-38\u00a0years). Two women had been diagnosed with polycystic ovarian syndrome, two were treated for hyperprolactinemia, two had hypothyroidism, of which one also had type 1 diabetes, one had a uterus malformation, one had anovulatory cycles, and one used a sperm donor.\nAll patients were able to undergo fertility treatment without experiencing severe porphyria attacks.\nWomen with acute hepatic porphyria considering fertility treatments should be assessed individually for potential risks, treatment should be planned in close collaboration with a porphyria specialist, and biochemical activity should be monitored regularly during ovarian stimulation. As we gather more knowledge, we hope that the porphyrinogenicity of the stimulation agents is re-assessed and that more studies will shed light on the reproductive health of women living with acute hepatic porphyria.",
    "authors": [
        {
            "affiliation": "Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.\nPorphyria Center Sweden, Center for Inherited Metabolic Diseases (CMMS), Karolinska University Hospital, Stockholm, Sweden.\nDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.",
            "firstname": "Daphne",
            "initials": "D",
            "lastname": "Vassiliou"
        },
        {
            "affiliation": "Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.\nDepartment of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.",
            "firstname": "Angelica",
            "initials": "A",
            "lastname": "Lind\u00e9n Hirschberg"
        },
        {
            "affiliation": "Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.\nPorphyria Center Sweden, Center for Inherited Metabolic Diseases (CMMS), Karolinska University Hospital, Stockholm, Sweden.\nDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.",
            "firstname": "Eliane",
            "initials": "E",
            "lastname": "Sardh"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).",
    "doi": "10.1111/aogs.14200",
    "journal": "Acta obstetricia et gynecologica Scandinavica",
    "keywords": [
        "acute hepatic porphyria",
        "assisted reproduction technologies",
        "in vitro fertilization",
        "porphyria",
        "porphyrinogenicity"
    ],
    "methods": null,
    "publication_date": "2021-06-02",
    "pubmed_id": "34060066",
    "results": "All patients were able to undergo fertility treatment without experiencing severe porphyria attacks.",
    "title": "Treatment with assisted reproduction technologies in women with acute hepatic porphyria.",
    "xml": "<Element 'PubmedArticle' at 0x788504de5710>"
}