Markers of Fertility in Adolescents With Chronic Endocrinopathies at Transition From Paediatric to Adult Care

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism Pub Date : 2024-06-07 DOI:10.1002/edm2.493

Daniela Choukair, Janna Mittnacht, Markus Bettendorf

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Abstract

Objective

During the process of transition from paediatric to adult health care, counselling concerning fertility is an important issue and is based mainly on serum markers of gonadal function. Here, we analysed these markers in adolescents with various underlying endocrine diseases at the time of transition.

Methods

After reaching near adult height and late puberty (girls: bone age [BA] ≥14 years, and boys: BA ≥16 years), we assessed stages of puberty according to Tanner and measured testes or ovarian volumes and serum markers of gonadal function (anti-Mullerian hormone [AMH], inhibin B, 17β-estradiol, testosterone).

Results

One hundred and ten patients (56 females and 54 males) were included from May 2010 to March 2016 with multiple pituitary hormone deficiency (MPHD; n = 17), growth hormone deficiency (GHD; n = 35), Turner syndrome (TS; n = 27), short stature after being born small for gestational age (SGA; n = 20) and Klinefelter syndrome (KS; n = 11). Female and male adolescents exhibited mature secondary sexual characteristics. The levels of serum inhibin B and AMH were lower in TS and female MPHD than in GHD and SGA, each independently (p < 0.05). The levels of serum AMH were higher whereas serum inhibin B were lower in male MPHD and KS (p < 0.05). Ovary volumes were significantly smaller in patients with TS, and testicular volumes were smaller in patients with KS.

Conclusions

After current established treatments with sex steroids, the development of secondary sexual characteristics was mature. However, impaired markers of fertility have been identified in patients with TS, KS and MPHD, reflecting gonadal dysgenesis in TS and KS, but gonadal immaturity in MPHD as gonadal gonadotropin stimulation is lacking throughout development. Consequently, in patients with MPHD, these markers cannot reliably predict individual fertility, which warrants consideration and incorporation in future treatment concepts.

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查看原文本刊更多论文

患有慢性内分泌疾病的青少年在从儿科护理向成人护理过渡时的生育能力指标。

目的：在从儿科医疗向成人医疗过渡的过程中，有关生育的咨询是一个重要问题，其主要依据是性腺功能的血清标志物。在此，我们对患有各种潜在内分泌疾病的青少年在过渡时期的这些指标进行了分析：方法：在身高接近成人且青春期晚期（女孩：骨龄[BA]≥14 岁，男孩：骨龄[BA]≥16 岁）后，我们根据坦纳标准评估青春期阶段，并测量睾丸或卵巢体积和性腺功能血清标志物（抗穆勒氏管激素[AMH]、抑制素 B、17β-雌二醇、睾酮）：2010年5月至2016年3月期间，110名患者（56名女性和54名男性）患有多发性垂体激素缺乏症（MPHD，17人）、生长激素缺乏症（GHD，35人）、特纳综合征（TS，27人）、小于胎龄儿出生后身材矮小（SGA，20人）和克莱恩费尔特综合征（KS，11人）。男女青少年均表现出成熟的第二性征。TS和女性MPHD的血清抑制素B和AMH水平低于GHD和SGA，各自独立（p 结论：TS和女性MPHD的血清抑制素B和AMH水平低于GHD和SGA：经过目前已确定的性类固醇治疗后，第二性征发育成熟。然而，在 TS、KS 和 MPHD 患者中发现了生育能力受损的标志物，这反映出 TS 和 KS 患者的性腺发育不良，而 MPHD 患者的性腺发育不成熟，因为在整个发育过程中缺乏促性腺激素的刺激。因此，这些标志物不能可靠地预测MPHD患者的生育能力，这值得考虑并纳入未来的治疗理念中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinology, Diabetes and Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

6 weeks