功能性下垂体 amenorrhoea 和多囊性卵巢形态:关于一个有趣的关联的叙事评论
Johannes Ott1, Geoffroy Robin2,3,4, Marlene Hager1
1Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Human reproduction update
|October 8, 2024
概括
具有多囊性卵巢形态 (PCOM) 的功能性下垂体 amenorrhea 影响了近一半的FHA患者. 这些女性表现出不同的荷尔蒙和代谢特征,需要仔细诊断才能区分PCOS.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 妇科 妇科 妇科 妇科
- 代谢健康 代谢健康
背景情况:
- 功能性下垂体 amenorrhoea (FHA) 是二次 amenorrhoea 的常见原因,经常呈现多囊性卵巢形态 (PCOM).
- FHA和PCOM之间的重叠可能导致多囊卵巢综合征 (PCOS) 的错误诊断.
- 现有研究表明,在PCOM和没有PCOM的FHA患者之间,内分泌和代谢特征可能存在差异.
研究的目的:
- 估计在被诊断为FHA的妇女中PCOM的患病率.
- 研究PCOM对FHA病理生理学,诊断和治疗的影响.
- 探索FHA患有PCOM的患者的潜在长期后果.
主要方法:
- 对同行评审的原始和评论文章进行系统审查.
- 在PubMed搜索中使用术语"多囊性和功能性下丘脑缺血症".
- 纳入标准:英语,年龄≥18岁,出版年份>1980,原始研究,经过验证的FHA和PCOM诊断.
主要成果:
- 在FHA患者中,PCOM患病率在41.9%至46.7%之间,高于健康对照组.
- 与没有PCOM的患者相比,FHA患者的BMI,AMH,和LH反应较高,SHBG较低.
- 在FHA-PCOM和PCOS (尤其是表型D) 之间进行差异诊断是具有挑战性的,有几个有用但不是最终的参数.
结论:
- 患有PCOM的FHA代表了一个独特的子组,需要在FHA和PCOS的临床指南中强调.
- 在FHA中PCOM的高患病率表明卵巢内卵巢调节的卵泡生成的变化,可能是由于遗传或表观遗传因素.
- 需要进一步的研究来了解FHA-PCOM的潜在机制和长期影响.
相关概念视频
Oogenesis
63.5K
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
63.5K
Hormonal Control of the Ovarian Cycle
426
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
426
Hormonal Regulation of the Menstrual Cycle
310
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
310
Ovarian Cycle
1.0K
The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
1.0K
Infertility in Females
288
Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...
Endometriosis, a condition characterized by abnormal growth of...
288
Menopause
143
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
143


