STRAW+10: Addressing the Unfinished Agenda of Staging Reproductive Aging - RESUBM

简介(申请人提供)：我们建议举办一个名为“STRAW+10：探讨未完成的生殖老化议程”的跨专业研讨会，以更新2001年生殖老化工作坊(STRAW)的建议。绝经过渡是一个关键的变化时期，包括生育能力丧失、骨吸收增加、血脂变化以及症状、睡眠障碍和抑郁的暂时性增加。Straw提出了命名法、分期系统以及月经和内分泌标准来定义卵巢老化的阶段。它已经成为描述生殖衰老的黄金标准，因为Tanner阶段描述了青春期。在过去的十年中，对月经末期前后下丘脑和卵巢功能的关键时刻及其对女性健康的影响的了解已经有了相当大的进步。我们将召集来自美国和世界各地关键研究小组的30名调查人员。其具体目的是根据新的基于人群的数据完善早期绝经过渡的标准；评估如何将体重指数较高和吸烟的妇女纳入分期算法；提供关于妇科手术、化疗和激素治疗后的妇女以及患有多囊卵巢综合征和艾滋病毒/艾滋病等慢性病的妇女的分期建议；以及评估可能的绝经后分期标准。第一天的公共科学会议将介绍最新的进展，并讨论新数据对分期的影响。在第二天，小型工作组将对稻草标准提出修改建议。在讨论之后，将通过最后建议并确定研究优先事项。预期的结果将是提出一系列建议，修改以生殖生命末期为特征的稻草标准，包括延长这些标准，使其更广泛地适用于妇女的各种经历。将明确短期和长期研究优先事项，包括复制和验证拟议标准以及解决知识差距所需的研究。这次会议由北美更年期学会(NAMS)、美国生殖医学学会、国际更年期学会和内分泌学会联合主办，将于2011年9月20日至21日在华盛顿举行的NAMS年会之前举行。NAMS会议将提交稻草+10项建议。同行评议的执行摘要将同时发表在联合发起人的期刊《更年期》、《更年期》、《生育》和《不孕症》上；非技术版本将在他们的网站上发表。STRAW+10分期系统将有助于对更年期状态进行一致的分类，确保研究研究和临床试验的可比性。一旦明确，分期系统就可以发展成一种临床工具，指导对生育力和避孕选择的评估，以及医疗决策。将拨出资金支持4名受训人员/新调查人员的参与。 与公共卫生的相关性：这一为期两天的多学科专题讨论会的目的是组织和综合过去十年积累的知识，以便更新2001年阶段的生殖老龄化研讨会(STRAW)模式，以期结束妇女的生殖生活。我们还建议扩大稻草建议，使其更广泛地适用于妇女在生殖老龄化方面的不同经历。

DESCRIPTION (provided by applicant): We propose a multi-disciplinary symposium "STRAW+10: Addressing the Unfinished Agenda of Staging Reproductive Aging" to update the 2001 Stages of Reproductive Aging Workshop (STRAW) recommendations. The menopausal transition is a period of critical change, including loss of fertility, increased bone resorption, change in lipid profiles and temporal increases in symptoms, sleep disturbances and depression. STRAW proposed nomenclature, a staging system, and menstrual and endocrine criteria to define stages of ovarian aging. It has become the gold standard for characterizing reproductive aging, as the Tanner Stages characterize puberty. In the past decade, understanding of the critical junctures in hypothalamic and ovarian function before and after the final menstrual period and their implications for women's health has advanced considerably. We will convene 30 investigators from key research groups in the United States and worldwide. The specific aims are to refine criteria for the early menopausal transition given new population-based data relating to follicle-stimulating hormone, antral follicle count, anti-mullerian hormone and inhibin-B; to assess how to include women with higher body-mass-index and who smoke in staging algorithms; to provide recommendations regarding staging of women following gynecological surgery, chemotherapy, and hormone therapy and in women with polycystic ovarian syndrome and chronic diseases such as HIV/AIDS; and to assess potential criteria for staging the post-menopause. The Day 1 public scientific sessions will present recent advances and discuss implications of new data for staging. On Day 2, small working groups will propose modifications to the STRAW criteria. Following discussion, final recommendations will be adopted and research priorities defined. The expected outcome will be a set of recommendations for modifying the STRAW criteria that characterize the end stages of reproductive life including their extension to be more broadly applicable to the range of women's experience. Short- and long-term research priorities will be specified including studies needed to replicate and validate proposed criteria as well as to address gaps in knowledge. The meeting, co-sponsored by The North American Menopause Society (NAMS), The American Society for Reproductive Medicine, The International Menopause Society and The Endocrine Society, will be held September 20-21, 2011 prior to the NAMS Annual Meeting in Washington D.C. STRAW+10 recommendations will be presented at the NAMS meeting. A peer-reviewed executive summary will be published simultaneously in the co-sponsors' journals, Climacteric, Menopause, Fertility and Sterility; with a non-technical version published on their websites. The STRAW+10 staging system will facilitate consistent classification of menopausal status, ensuring comparability of research studies and clinical trials. Once specified, a staging system can be developed into a clinical tool to guide assessment of fertility and contraceptive choices, and healthcare decision-making. Funds will be allocated to support participation of 4 trainees/new investigators. PUBLIC HEALTH RELEVANCE: The purpose of this multi-disciplinary 2-day symposium is to organize and synthesize knowledge accumulated during the past decade in order to update the 2001 Stages of Reproductive Aging Workshop (STRAW) model for staging the end of reproductive life in women. We also propose to extend the STRAW recommendations to be more broadly applicable to the range of women's diverse experience of reproductive aging.