The goal of this study is to see whether kisspeptin, a naturally occurring hormone, can stimulate the release of other reproductive hormones in women with hypothalamic amenorrhea (HA). The investigators are also examining whether kisspeptin can help women release eggs from their ovaries. Kisspeptin will be administered subcutaneously (SC) for two weeks in a pulsatile fashion. Ultrasound monitoring of ovarian follicular growth and frequent blood sampling (every 10 minutes for up to two hours) will be performed to assess the physiologic response to kisspeptin over time.
Assignment: All study subjects will undergo the same interventions. Delivery of Interventions: * The subject will undergo a review of their medical history, physical exam, and screening laboratories. * A pelvic ultrasound will be performed to assess baseline follicular size. * A pump will be placed to administer pulsatile SC kisspeptin for two weeks. * During the course of kisspeptin administration, subjects will * Undergo q10 min blood sampling (approximately 4 sessions, 2 hours each) * Undergo pelvic ultrasounds (approximately 4 sessions) * Optional q10 min sampling up to 10 hours may take place before and after the course of kisspeptin
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
13
SC administration of kisspeptin for two weeks (pulsatile, approximately every 90 minutes)
Massachusetts General Hospital
Boston, Massachusetts, United States
The proportion of participants that achieve development of a mature follicle or show evidence of ovulation
Mature follicle achievement is defined as evidence of a follicle with maximum diameter ≥18 mm. Evidence of ovulation is defined as detection of a corpus luteum on ultrasound in combination with elevated progesterone level.
Time frame: 2 weeks
Change of luteinizing hormone (LH) pulse amplitude
Difference in LH amplitude on the first day of kisspeptin administration vs the last day of kisspeptin administration
Time frame: 2 weeks
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