A case of recurrent Cushing’s disease with optimised perinatal outcomes

Hypercortisolism suppresses gonadotropin release, leading to menstrual irregularities and infertility. In CD, hypersecretion of both androgens and cortisol further contributes to higher rates of amenorrhoea and infertility. Pregnancy itself is a state of hypercortisolism, with very few studies detailing normal ranges of cortisol in each trimester of pregnancy for midnight salivary cortisol and urinary free cortisol testing. Treatment of CD reduces maternal morbidity and rates of foetal loss, and can be either surgical (preferred) or medical. CD can relapse, often many years after initial surgery. There are a limited number of cases of Cushing's syndrome in pregnancy, therefore, the best possible treatment is difficult to determine and should be individualised to the patient.