Central precocious puberty in girls: Internal genitalia before, during, and after treatment with long-acting gonadotropin-releasing hormone analogues☆,☆☆,★
Section snippets
Patients
Thirty-three girls with the diagnosis of idiopathic CPP were included in the study. The diagnosis was based on development of secondary sexual characteristics before 9 years of age, increased height velocity, advanced bone age, pubertal response to GnRH test, and serum estradiol greater than prepubertal levels. Median age at the beginning of treatment was 8.5 years (6.5 to 10.5). Three girls had had menarche at the time of diagnosis.
Treatment
All girls received a long-acting GnRH analogue (Decapeptyl
Results
Results from the first 24 months of treatment and from follow-up examinations 3 to 20 months after discontinuation were used for analyses.
Discussion
In accordance with previous studies, we demonstrated enlarged ovaries at the time of diagnosis of central precocious puberty.12, 19 We also demonstrated as did earlier investigations9, 10, 20 that ovarian volume decreased significantly during treatment and returned to values appropriate for age. In contrast, a recent study could not document significant reduction during treatment, although in this investigation, findings were compared with age-matched control subjects as well.12 It was
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Cited by (61)
New insights into the role of LH in early ovarian follicular growth: a possible tool to optimize follicular recruitment
2023, Reproductive BioMedicine OnlinePrecocious Puberty
2015, Endocrinology: Adult and PediatricInfant toxicology: State of the science and considerations in evaluation of safety
2014, Food and Chemical ToxicologyCitation Excerpt :Since biliary excretion is a common and important clearance process for chemicals, more information is needed related to biliary excretion capacity of neonates and infants through 6 months of age. Determination of critical events in reproductive or endocrine system maturation that occur during the first 6 months of life and perturbations of which may cause latent or delayed adverse effects: The human reproduction system is immature at birth and undergoes maturational processes during puberty (8–14 years of age), when the HPG and HPA axes reactivate (Biro et al., 2008; Jensen et al., 1998). Infants are exposed to a large variety of hormones from maternal transfer prior to birth that lasts into the postnatal period (Grumbach, 2002; Laurence et al., 1991) as well as through nutrition in breast milk and formula during early postnatal life (Borgert et al., 2003), and it is unclear how sensitive infants are to perturbation by hormonally active chemicals during the first 6 months.
Serum levels of antimüllerian hormone in early maturing girls before, during, and after suppression with GnRH agonist
2012, Fertility and SterilityCitation Excerpt :This may explain why AMH levels do not decrease as a response to restarting pubertal development after discontinuation of GnRH-a. However, this remains speculative. As expected, larger ovarian follicles reappear after discontinuation of GnRH-a in girls with CPP (23), and we believe that the recovery of AMH indicates a normalized redistribution of ovarian follicles after recovery from gonadotropin suppression. As it was unlikely that temporary pituitary suppression would affect the number of resting follicles, the recovery of AMH after discontinuation of GnRH-a was anticipated.
Prevalence of polycystic ovary syndrome in young women who had idiopathic central precocious puberty
2010, Fertility and SterilityCitation Excerpt :Relationships among ovarian histology, architecture as perceived by ultrasound, and function are not estabilished, but PCOM seems to be a marker for excessive thecal androgen production, even if in some patients with PCOM thecal androgen excess is not manifest as hyperandrogenemia, the reason for which is not known (38). The prevalence of PCOS in our subjects was 32% using the Rotterdam 2003 criteria and 30% using the AES criteria, higher than the prevalence reported by other authors in patients who had ICPP (16–18), but older criteria for PCOS were used in those studies. Abnormal gonadotropin dynamics with excess ovarian production of androgens and PCOM may occur despite the treatment with GnRH agonist in patients who had ICPP.
Precocious Puberty
2010, Endocrinology: Adult and Pediatric, Sixth Edition
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From the Department of Growth and Reproduction and the Department of Obstetrics and Gynecology, Rigshospitalet, State University Hospital, Denmark.
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Reprint requests: Anne-Mette Bæk Jensen, Bavnestien 4, 2850 Nærum, Denmark.
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