Update in female reproduction: A life-cycle approach
Update in female reproduction: A life-cycle approach
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DOI：
10.1210/jc.2008-0752
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发表时间：
2008-07-01
影响因子：
5.8
通讯作者：
Barbieri, Robert L.
中科院分区：
文献类型：
--
作者：
Barbieri, Robert L.
内容：女性生殖跨越了从胎儿期到儿童期，从青春期到生育期，最后到卵巢卵泡耗竭和绝经期的开始的一个发育生命弧。目的：这篇特邀综述突出了过去2年来来自主要期刊的一些报道，这些报道显著地促进了我们对女性生殖从受孕到绝经的理解。在胎儿期，子宫内暴露可能是后期青春期和成人内分泌生理学的重要决定因素。表观遗传机制可能参与了胎儿对成人内分泌功能的编程。关于多囊卵巢综合征，最近的临床试验已经证实了克罗米芬对患有这种疾病的妇女的排卵诱导的核心作用。此外，一个专家小组建议所有患有多囊卵巢综合征的妇女进行葡萄糖耐量试验，因为这一人群中葡萄糖耐量受损的患病率很高。在绝经期妇女中，雌激素治疗对心血管生物学的确切影响仍有待充分阐明。不断发展的数据表明，当开始接近绝经期的发病，雌激素治疗有更少的心血管疾病的风险比当它是管理几十年后的menopaus.Conclusions：生殖的本质是生殖系DNA的成功传输到下一代。遗传学和内分泌学的进展正在融合，以显着提高我们对生殖生物学的理解和我们影响生殖过程的能力。这些进展将转化为新的治疗方法，用于普遍存在的生殖医学问题。
Context: Female reproduction spans a developmental life arc from fetal life and childhood, through puberty to the reproductive years, and, finally, ovarian follicle depletion and the onset of menopause.Objective: This invited review highlights a selection of reports from leading journals over the past 2 yr that have significantly advanced our understanding of female reproduction from conception to menopause.Synthesis: During fetal life, in utero exposures may be important determinants of later pubertal and adult endocrine physiology. Epigenetic mechanisms are likely involved in the fetal programming of adult endocrine function. With regards to the polycystic ovary syndrome, recent clinical trials have confirmed the central role of clomiphene for ovulation induction in women with this disease. In addition, an expert panel has recommended that all women with polycystic ovary syndrome have a glucose tolerance test because of the high prevalence of impaired glucose tolerance in this population. In menopausal women the precise impact of estrogen therapy on cardiovascular biology remains to be delineated fully. Evolving data indicate that when initiated near the onset of menopause, estrogen therapy has fewer cardiovascular risks than when it is administered decades after the menopause.Conclusions: The essence of reproduction is the successful transmission of germ-line DNA to a succeeding generation. Advances in genetics and endocrinology are converging to advance significantly our understanding of the biology of reproduction and our ability to influence reproductive processes. These advances will translate into new treatments for the prevalent medical problems of reproduction.