Potential impact of mini-puberty on fertility

Nordenström, Anna

doi:10.1016/j.ando.2022.06.002

Cited by 3 publications

(4 citation statements)

References 52 publications

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“…In foetal life, in the middle of pregnancy, gonadotrophins reach high concentrations; however, due to the increasing levels of placental oestrogens, and in male foetuses probably also testosterone, their suppression occurs [ 10 , 15 ]. After delivery, as the level of placental hormones has decreased, the hypothalamic-pituitary-gonadal axis is unlocked, and as a result we observe changes known as minipuberty [ 15 , 16 ]. In boys, concentrations of LH and FSH, testosterone, 17-OHP, and androstenedione reach maximum values in the first 3 months of life and then decrease to pre-pubertal values at about 6-9 months of age [ 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…In both sexes, it is vital for future reproductive capacity [ 19 ]. In the case of males, transient stimulation of the testes is important for priming Leydig and Sertoli cells and gonocyte-to-spermatogenic stem cell (also called spermatogonia) transformation, which serve as a lifetime source of spermatogenesis [ 14 , 16 , 19 , 20 ]. It plays pivotal roles in brain masculinization and the development of sexual orientation [ 7 , 10 , 11 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, minipuberty provides a temporary window for diagnosis and potential treatment in infants with disorders of sex development [ 13 ]. Effective treatment for micropenis could be advised during minipuberty, but it is not clear whether gonadotropin therapy in children with congenital hypogonadotropic hypogonadism would improve fertility in the future [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Premature pubarche during minipuberty – literature review and two case reports

Rakuś-Kwiatosz¹,

Budzyńska²,

Ben-Skowronek³

2023

pedm

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Introduction Isolated premature pubarche (PP) in infancy may be the reason for many diagnostic difficulties. This is due to the low incidence and, therefore, the limited number of studies on this subject and the lack of strict laboratory standards because of the physiological variability of gonadotropic hormone and androgen concentrations during minipuberty. Material and methods We aimed to present current knowledge about PP in infancy based on the literature review and 2 cases of male infants with scrotal hair during minipuberty. Results Isolated hair in the pubic region in a boy during the period of minipuberty requires differential diagnosis. After excluding serious aetiology, it seems to be a mild, self-limiting variant of precocious puberty. The phenomenon is probably a result of increased sensitivity of the hair follicles to transiently increased androgen concentration. Conclusions Isolated pubic hair in infancy as a mild, self-limiting variant of precocious puberty in infants should be a diagnosis of exclusion. The condition resolves spontaneously, but it absolutely requires further follow-up to exclude serious aetiology in the case of puberty progression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Premature pubarche during minipuberty – literature review and two case reports

Rakuś-Kwiatosz¹,

Budzyńska²,

Ben-Skowronek³

2023

pedm

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“…In males, the hypothalamic–pituitary–gonadal axis is normally activated from birth to 6 months of age, manifesting as “mini-puberty,” leading to a rise in gonadotropins (LH and FSH) and sex steroids and resultant penile and testicular growth. 5 , 6 In healthy males, FSH leads to the proliferation of Sertoli cells in the testes and, hence, testicular growth, facilitating post-pubertal spermatogenesis. During the mini-puberty period, Sertoli cells do not express androgen receptors, so spermatogenesis is not stimulated in infancy.…”

Section: Introductionmentioning

confidence: 99%

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Alexander,

Faruqi,

Farquhar

et al. 2023

European Journal of Endocrinology

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Objective Hypogonadotropic hypogonadism is characterised by inadequate secretion of pituitary gonadotropins, leading to absent, partial or arrested puberty. In males, classical treatment with testosterone promotes virilisation but not testicular growth or spermatogenesis. To quantify treatment practices and efficacy, we systematically reviewed all studies investigating gonadotropins for achievement of pubertal outcomes in males with hypogonadotropic hypogonadism. Design Systematic review and meta-analysis Methods A systematic review of Medline, EMBASE, Global Health, and PsychInfo databases in December 2022. Risk of Bias 2.0/Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I)/National Heart, Lung, and Blood Institute (NHLBI) tools for quality appraisal. Protocol registered on PROSPERO (CRD42022381713). Results After screening 3,925 abstracts, 103 studies were identified including 5,328 patients from 21 countries. Average age of participants was <25 years in 45.6% (n=47) of studies. Studies utilised human chorionic gonadotropin (hCG) (n=93, 90.3% of studies), human menopausal gonadotropin (hMG) (n=42, 40.8%), follicle-stimulating hormone (FSH) (n=37, 35.9%), and gonadotropin-releasing hormone (GnRH) (28.2% n=29). Median reported duration of treatment/follow-up was 18 months (interquartile range (IQR) 10.5-24 months). Gonadotropins induced significant increases in testicular volume, penile size and testosterone in over 98% of analyses. Spermatogenesis rates were higher with hCG + FSH (86%, 95% Confidence Interval (CI) 82-91%) as compared to hCG alone (40%, 95% CI 25-56%). However, study heterogeneity and treatment variability were high. Conclusions This systematic review provides convincing evidence of efficacy of gonadotropins for pubertal induction. However, there remains substantial heterogeneity in treatment choice, dose, duration, and outcomes assessed. Formal guidelines and randomised studies are needed.

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Anti-Müllerian hormone beyond an ovarian reserve marker: the relationship with the physiology and pathology in the life-long follicle development

Iwase,

Hasegawa,

Tsukui

et al. 2023

Front. Endocrinol.

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Anti-Müllerian hormone (AMH), an indirect indicator of the number of remaining follicles, is clinically used as a test for ovarian reserve. Typically, a decline suggests a decrease in the number of remaining follicles in relation to ovarian toxicity caused by interventions, which may implicate fertility. In contrast, serum AMH levels are elevated in patients with polycystic ovary syndrome. AMH is produced primarily in the granulosa cells of the preantral and small antral follicles. Thus it varies in association with folliculogenesis and the establishment and shrinking of the follicle cohort. Ovarian activity during the female half-life, from the embryonic period to menopause, is based on folliculogenesis and maintenance of the follicle cohort, which is influenced by developmental processes, life events, and interventions. AMH trends over a woman’s lifetime are associated with in vivo follicular cohort transitions that cannot be observed directly.

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Potential impact of mini-puberty on fertility

Cited by 3 publications

References 52 publications

Premature pubarche during minipuberty – literature review and two case reports

Premature pubarche during minipuberty – literature review and two case reports

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Anti-Müllerian hormone beyond an ovarian reserve marker: the relationship with the physiology and pathology in the life-long follicle development

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