Empty sella syndrome is associated with hypopituitarism and with deficiency of growth hormone. Infertility in hypopituitarism patients is caused by LH and FSH deficiency leading to sex hormone abnormalities and insufficient egg and sperm maturation. In men, a hormone replacement treatment for one year or more is needed to achieve a sperm count adequate to father a baby.
Unexplained infertility may be also a result of growth hormone deficiency due its role in reproductive system. In men, it controls male sexual maturation and adult reproductive function. It affects gonadal differentiation, steroidogenesis (steroid hormones production by ovaries, testes and brain), gametogenesis (gamete formation), and gonadotropin secretion and responsiveness. In women, it acts as a modulator on gonadotropins and follicular maturation. So, growth hormone deficiency may be tested as a possible cause of unexplained infertility.
Before pregnancy, the hormone levels should be restored to normal level. Pregnancies resulting from fertility treatment of hypopituitarism are associated with an increased risk of pregnancy complications such as abortion, anemia, pregnancy-induced hypertension, placental abruption, premature birth, and postpartum hemorrhage. In those patients, close monitoring is necessary as changes may need to be made to their medications. Ultrasounds measurement is also needed for fetal growth assessment.