NEUROPSYCHOLOGICAL DYSFUNCTION IN WOMEN FOLLOWING LEUPROLIDE ACETATE INDUCTION OF HYPOESTROGENISM

Objective: The study investigated the neuropsychological status of women 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 fertilization clinic. Interventions: Leuprolide acetate was administered to all subjects as part of in vitro fertilization. Methods: Eighteen women receiving in vitro fertilization treatment underwent neuropsychological testing before, during, and after treatment with leuprolide acetate and 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 the tests administered, some individuals showed significant cognitive deficits during therapy particularly in the areas of memory, fine motor coordination, and two-point discrimination. Two of the 18 subjects showed very substantial neuropsychological sequelae including memory gaps and disturbances in a variety of neuropsychological test performances. However, in terms of group statistics, only two-point discrimination and delayed recall memory test performance proved significant. Not all measures were sensitive for the group, as many tests displayed a balance between individuals who showed practice effects and those who showed detrimental effects. Conclusions: For a substantial portion of individuals, hypoestrogenism can result in statistically significant or clinically noteworthy problems with memory, dexterity, and two-point discrimination.