{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:28:58Z","timestamp":1790998138598,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We 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\u201338\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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were able to undergo fertility treatment without experiencing severe porphyria attacks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women 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\u2010assessed and that more studies will shed light on the reproductive health of women living with acute hepatic porphyria.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14200","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T08:42:24Z","timestamp":1622536944000},"page":"1712-1721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment with assisted reproduction technologies in women with acute hepatic porphyria"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1612-5986","authenticated-orcid":false,"given":"Daphne","family":"Vassiliou","sequence":"first","affiliation":[{"name":"Department of Endocrinology Karolinska University Hospital Stockholm Sweden"},{"name":"Porphyria Center Sweden Center for Inherited Metabolic Diseases (CMMS) Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Lind\u00e9n Hirschberg","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Karolinska Institutet Stockholm Sweden"},{"name":"Department of Gynecology and Reproductive Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliane","family":"Sardh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Karolinska University Hospital Stockholm Sweden"},{"name":"Porphyria Center Sweden Center for Inherited Metabolic Diseases (CMMS) Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-05-423186"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29313"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.67.3.1315"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197206152862401"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-012-9544-4"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1297"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116348"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0306-5251.2007.02955.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(18)96783-9"},{"key":"e_1_2_11_11_1","first-page":"10","article-title":"LHRH analogues for hormonal manipulation in acute intermittent porphyria","volume":"26","author":"Anderson KE","year":"1989","journal-title":"Semin Hematol"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.12.065"},{"key":"e_1_2_11_13_1","first-page":"201","article-title":"Acute intermittent porphyria associated with ovarian stimulation. A case report","volume":"48","author":"Seiden WB","year":"2003","journal-title":"J Reprod Med"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1967.10664873"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00207051"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/humu.1380010508"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0004.2003.00116.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0004.2002.620406.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.32.12.979"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00197173"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016340903390729"},{"key":"e_1_2_11_22_1","first-page":"36","article-title":"Genetik och metabola forlopp bakom den akuta porfyriattacken \u2010 Mer an hundra lakemedel ar potentiellt livshotande vid akut porfyri. [Genetics and metabolic processes behind the acute porphyria attack \u2013 More than a hundred drugs are potentially life\u2010threatening in acute porphyria]","volume":"113","author":"Thunell S","year":"2016","journal-title":"Lakartidningen"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01172.x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.7.2.159"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2011.06.001"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01172.x"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-6-200503150-00010"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-36-4-1111"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-47-4-834"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.08.032"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2015.08.025"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14200","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14200","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14200","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T18:39:41Z","timestamp":1692815981000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,19]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/aogs.14200"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14200","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,19]]},"assertion":[{"value":"2021-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}