Postnatal Developmental Changes in the Pituitary-Ovarian Axis in Preterm and Term Infant Girls

Kuiri-Hänninen, Tanja; Kallio, S.; Seuri, Raija; Tyrväinen, Erja; Liakka, Annikki; Tapanainen, Juha S.; Sankilampi, Ulla; Dunkel, Leo

doi:10.1097/ogx.0b013e318254713b

Cited by 14 publications

(25 citation statements)

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“…Puberty is regulated by the HPG axis. The axis is active in utero and shortly after birth 62,63 (a phenomenon referred to as mini-puberty), is subsequently silenced and remains quiescent for years until reawakening at the onset of puberty. Multiple central and peripheral inputs are integrated into pubertal reacti vation of the GnRH pulse generator.…”

Section: Puberty and Reproductionmentioning

confidence: 99%

“…62,63,70,130 Female neonates born to parents with CHH should undergo biochemical evaluation; serum levels of FSH during the mini-puberty seem to be the most sensitive indicator of CHH in this setting. 131 During childhood, diagnosis of CHH is very challenging as this interval is a physiologically hypogonadal period of development.…”

Section: Clinical Biochemical and Imaging Investigationsmentioning

confidence: 99%

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European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Section: Puberty and Reproductionmentioning

confidence: 99%

Section: Clinical Biochemical and Imaging Investigationsmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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“…Increased FSH in girls continues until the age of 2-4 years. In girls, the level of estradiol is high in the 2-4 th months after delivery (the levels may fluctuate) (31). Inhibin-B reaches a peak in the first four months and is maintained at the prepubertal level until the age of 2 years.…”

Section: Mini Puberty and Its Interpretation Invited Reviewmentioning

confidence: 99%

“…The level of FSH is higher in girls. The hormones excluding follicle stimulating hormone decrease from the 6 th month after delivery (31). Increased FSH in girls continues until the age of 2-4 years.…”

Section: Mini Puberty and Its Interpretation Invited Reviewmentioning

confidence: 99%

Mini puberty and its interpretation

Kurtoğlu

Baştuğ

2014

Turk Arch Ped

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Gonadotropins which are at high levels in the middle of the fetal life are considerably low in the cord blood and estrogen is measured to be high. The reason for this is the inhibitory effect of increased estrogen levels in the circulation arising from the placenta on gonadotropin releasing hormone (GnRH) pulse generator and pituitary gonadotropins (1, 2). In male fetuses, testosterone levels probably contribute additionally to inhibition (3). Gonadotropin inhibition discontinues with placental seperation, the hypothalamo-pituitary-gonadal axis is activated and the hormonal changes which occur are identified as mini puberty (2, 4). The activation of the hypothalamo-pituitary-gonadal axis reach a peak level approximately in the 6-8th week after delivery. In this period, the levels of sex steroids are similar to early-middle pubertal levels, but their peripheral effects are not realized (4).In boys, the level of luteinizing hormone (LH) increases approximately 10-fold in the minutes following delivery and the level of tesosterone increases. This state lasts approximately for 12 hours (5, 6). The increase in follicle stimulating hormone (FSH) and LH continues in the second week after delivery, reaches a peak in the 4-10 th week, decreases in the 6 th month to the prepubertal levels. The level of testosterone increased by release of luteinizing hormone reaches a peak at around the third month and decreases to the prepubertal levels in the 6-9 th months (1,7,8). Similarly, the levels of 17-hydroxyprogesteron and androstenodione which are increased with testosterone decrease with reduction of the level of LH (2). After delivery, an increase in the number of Leydig cells starts. This increase reaches a peak in the third month. Afterwards, reduction and apopytosis occur in fetal and infantile Leydig cells (9-11). Inhibin-B is a glycoprotein belonging to the family of transforming growth factor beta (TGF-β) and is released from Sertoli cells in the prepubertal period. It is considered an indicator of sertoli cell function in prepubertal male children, but it does not reflect the number and function of germ cells. Inhibin-B acts as a regulator of release of FSH (1). Inhibin-B can be measured in the cord blood, it increases after delivery, reaches a peak in the 4-12 th month (exceeds the male adult level). It is at a considerably low level at the age of 3-9 years and increases again with the initiation of the puberty (3, 7). Serum inhibin-B levels are low in cases of hypogonadotropic hypogonadism (1, 12).Anti-Mullerian hormone (AMH) is a glycoprotein released from the sertoli cells starting from the fetal period. It is found in the cord blood and its level increases in the first 30 months after delivery. It reaches a peak in the 6 th month, starts to decrease Mini puberty and its interpretation AbstractGonadotropins which are high in the middle of the fetal life are measured to be considerably low in the cord blood and estrogen is found to be high in the cord blood. Gonodotropins are supressed by estrogen. After delivery,...

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“…Its purpose remains unclear, but is most commonly thought to be an important developmental event related to subsequent reproductive function. 2,3 Mini-puberty occurs in both sexes, with an increase in testosterone in boys and increase in both estradiol and testosterone in girls (testosterone concentrations in girls are ∼30% lower than those in boys at peak). Resultant effects on the reproductive organs include testicular, penile, and prostate growth in boys, uterine and breast enlargement in girls, and sebaceous gland and acne development in both sexes.…”

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confidence: 99%