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Fetale Programmierung der gonadalen Reifung

Fetal programming of gonadal maturation

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Es gibt zunehmende Hinweise, dass eine frühe intrauterine fetale (Fehl-)Programmierung nicht nur Auswirkungen auf die kardiovaskuläre und metabolische Regulation im späteren Leben hat, sondern dass auch die reproduktive Funktion dadurch beeinflusst wird. Eine intrauterine Wachstumsretardierung kann mit einer vorzeitigen Reifung der gonadalen Funktion und einer Vorverlegung der Pubertät und des Menarchealters verbunden sein. Insbesondere durch pränatale Androgeneffekte werden sowohl die Entwicklung von Ovarien und äußeren Genitalien selbst als auch die neuroendokrine Regulation der hypothalamisch-hypophysär-ovariellen Achse ungünstig beeinflusst, sodass im späteren Leben häufiger ein polyzystisches Ovarialsyndrom mit Hyperandrogenämie und Ovulationsstörungen auftritt. Diese tierexperimentell klar nachweisbaren Zusammenhänge bedürfen jedoch noch weiterer Belege durch epidemiologische und klinische Untersuchungen am Menschen.

Abstract

There is increasing evidence suggesting that (faulty) early intrauterine fetal programming not only determines cardiovascular and metabolic regulation in later life, but also influences reproductive function. Intrauterine growth restriction may be related to precocious maturation of gonadal function, with earlier onset of puberty and earlier menarche. Prenatal effects of androgens in particular have a negative influence on the development of the ovaries and external female genitalia, and also on the neuroendocrine feedback regulation of the hypothalamic-pituitary-gonadal axis, making polycystic ovary syndrome with hyperandogenism and anovulation more likely than would otherwise be the case in later life. These links have been clearly demonstrated in animal experiments, but further confirmation in human subjects is needed, which will require epidemiological and clinical trials.

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  1. Abteilung Geburtshilfe, Klinik für Frauenheilkunde und Geburtshilfe, Klinikum der Friedrich-Schiller-Universität Jena, Bachstraße 18, 07743, Jena, Deutschland

    Ekkehard Schleußner

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Schleußner, E. Fetale Programmierung der gonadalen Reifung. Gynäkologe 40, 272–278 (2007). https://doi.org/10.1007/s00129-007-1975-x

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  • DOI: https://doi.org/10.1007/s00129-007-1975-x

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