NEUROPSYCHOLOGICAL DYSFUNCTION IN WOMEN FOLLOWING LEUPROLIDE ACETATE INDUCTION OF HYPOESTROGENISM

Objective: The study investigated the neuropsychological status of wom en with induced hypoestrogenism. Design: An ABA design was employed in which neuropsychological measures were repeated prior to, during, and after induction of hypoestrogenism with leuprolide acetate. Setting: The study took place in a medical school affiliated in vitro fertiliza tion clinic. Interventions: Leuprolide acetate was administered to all subjects as part of in vitro fertilization. Methods: Eighteen women r eceiving in vitro fertilization treatment underwent neuropsychological testing before, during, and after treatment with leuprolide acetate a nd gonadotrophins. The neuropsychological test battery was selected on the basis of previous patients' symptomatic complaints during periods of hypoestrogenism with leuprolide acetate. Results: Depending upon t he tests administered, some individuals showed significant cognitive d eficits during therapy particularly in the areas of memory, fine motor coordination, and two-point discrimination. Two of the 18 subjects sh owed very substantial neuropsychological sequelae including memory gap s and disturbances in a variety of neuropsychological test performance s. However, in terms of group statistics, only two-point discriminatio n and delayed recall memory test performance proved significant. Not a ll measures were sensitive for the group, as many tests displayed a ba lance between individuals who showed practice effects and those who sh owed detrimental effects. Conclusions: For a substantial portion of in dividuals, hypoestrogenism can result in statistically significant or clinically noteworthy problems with memory, dexterity, and two-point d iscrimination.