Long-term GnRH agonist treatment for female central precocious puberty does not impair reproductive function

Heger, Sabine; Müller, Mario; Ranke, Michael B.; Schwarz, Hans‐Peter; Waldhauser, Franz; Partsch, Carl-Joachim; Sippell, Wolfgang G.

doi:10.1016/j.mce.2006.04.012

Cited by 82 publications

(61 citation statements)

References 10 publications

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“…At callback of adult subjects we did not find impairment in reproductive function, consistent with previous studies [6, 8, 13, 30]. A study by Heger et al reported 12 pregnancies in 34 women who wished to have children [6].…”

Section: Discussionsupporting

confidence: 91%

“…The resumption of puberty was also evidenced by progression of Tanner stages in both females and males. In females, the mean time to onset of menses was approximately 1.5 years, consistent with previous studies in females treated with GnRHa, in which the interval ranged from 2 to 61 months, with an average of approximately 16 months [6, 13, 26–28]. Furthermore, the mean age at the onset of menarche or re-menarche in our study was 12.9 years, which is consistent with the average age of menarche of 12.53 years in the US [29].…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Neely

Lee

Bloch

et al. 2010

International Journal of Pediatric Endocrinology

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Methods. This prospective US multicenter trial of leuprolide acetate 1-month depot (7.5–15 mg) for central precocious puberty utilized an open-label treatment period, long-term follow-up, and adult callback. Forty-nine females <9 years old with Tanner breast stage ≥2 before 8 years and 6 males <10 years old with Tanner genital stage ≥2 before 9 years with stimulated LH ≥10 IU/L and bone age advance ≥1 year were enrolled. Results. Subjects were treated for 3.9 ± 2.0 years. Mean peak GnRH-stimulated LH and FSH were prepubertal after the first dose and remained suppressed throughout treatment. During treatment, mean estradiol decreased to the limit of detection and mean testosterone decreased but remained above prepubertal norms. During posttreatment follow-up (3.5 ± 2.2 years), all patients achieved a pubertal hormonal response within 1 year and menses were reported in all females ≥12 years old. No impairment of reproductive function was observed at adulthood (mean age: 24.8 years).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Neely

Lee

Bloch

et al. 2010

International Journal of Pediatric Endocrinology

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“…Feuillan et al (40) described the ovarian volume larger than normal at 4-5 years post-treatment, whereas another study including adult CPP-treated women showed the ovarian volume within normal range (52). Ovarian volume O10 ml was observed in 20% of CPP-treated patients (49,50), a percentage similar to that found in age-matched, healthy controls (48). CPP patients with regular vs irregular menses showed no differences in the ovarian volume (22).…”

Section: Reproductive Function and Risk Of Polycystic Ovarian Syndromementioning

confidence: 90%

“…These findings suggest, according to the authors, a protective role for gonadotropin suppressive treatment on the reproductive outcome of CPP women. PCO morphology detected by ultrasound (US) was reported in 0-37% of treated CPP girls (median 2%) (21,36,46,47,48,49,50,51), with different lengths of posttreatment follow-up (up to 20 years), as summarized in Supplementary Table 4, see section on supplementary data given at the end of this article. Feuillan et al (40) described the ovarian volume larger than normal at 4-5 years post-treatment, whereas another study including adult CPP-treated women showed the ovarian volume within normal range (52).…”

Section: Reproductive Function and Risk Of Polycystic Ovarian Syndromementioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Guaraldi

Beccuti

Gori

et al. 2016

European Journal of Endocrinology

113

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GnRH analogues (GnRHa) are the treatment of choice for central precocious puberty (CPP), with the main objective to recover the height potential compromised by the premature fusion of growth cartilages. The aim of this review was to analyze longterm effects of GnRHa on height, body weight, reproductive function, and bone mineral density (BMD) in patients with CPP, as well as the potential predictors of outcome. Because randomized controlled trials on the effectiveness and long-term outcomes of treatment are not available, only qualified conclusions about the efficacy of interventions can be drawn. GnRHa treatment appears to improve adult height in girls with CPP, especially if diagnosed before the age of 6, whereas a real benefit in terms of adult height is still controversial in patients with the onset of puberty between 6 and 8 years of age. No height benefit was shown in patients treated after 8 years. Gonadal function is promptly restored in girls after cessation of treatment, and reproductive potential appears normal in young adulthood. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Fat mass is increased at the start of treatment but normalizes thereafter, and GnRHa itself does not seem to have any long-term effect on BMI. Similarly, analogue treatment does not appear to have a negative impact on BMD. Owing to the paucity of data available, no conclusions can be drawn on the repercussions of CPP and/or its treatment on the timing of menopause and on the health of the offspring.

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“…Again, the information is confined mainly to females. Mean time to menarche post-treatment is 16 months with normal pattern of menses; reproductive potential appears normal in young adulthood with healthy offspring of those who became pregnant (31,35). There appears to be no increased risk of ovulatory dysfunction associated with factors such as hirsutism and polycystic ovary syndrome, and GnRHa treatment per se does not lead to obesity.…”

Section: Long-term Outcome Data After Gnrha Treatmentmentioning

confidence: 99%

The use of GnRH agonists in precocious puberty

Mul¹,

Hughes

2008

European Journal of Endocrinology

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In this review several aspects of gonadotrophin releasing hormone agonists (GnRHa) treatment in central precocious puberty (CPP) are highlighed. These include issues of the definition of precocity, assessment of CPP and thelarche variants. Indications for treatment with GnRH agonists are discussed, not only in CPP but also in children with other reasons to suppress central activation, e.g. adopted or developmental retardation. Finally, outcome data are summarized, both on growth and psychosocial parameters.European Journal of Endocrinology 159 S3-S8

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Long-term GnRH agonist treatment for female central precocious puberty does not impair reproductive function

Cited by 82 publications

References 10 publications

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

The use of GnRH agonists in precocious puberty

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