Abstract:
:Pregnancy results in major changes in the hypothalamo-pituitary-adrenal (HPA) axis, which in turn influence fetal growth and the timing of labor. From the beginning of the second trimester maternal cortisol secretion increases, and in late pregnancy the placenta, in large part mediated through corticotroph-releasing hormone, plays a crucial role in the regulation of the fetal HPA axis to ensure the synchronization of the various processes involved in parturition. Exposure of the fetus to excess glucocorticoid results in intrauterine growth failure and possibly "programs" the development of cardiovascular disease in adult life. Biochemical assessment of the HPA axis is complicated by the estrogen-induced elevation of circulating cortisol-binding globulin, resulting in misleadingly high circulating cortisol levels The hypercortisolemia of Cushing's syndrome causes infertility, but if pregnancy does occur it can result in increased morbidity and mortality in mother and fetus. However, the prospects of a successful pregnancy are greatly improved with control of hypercortisolemia by surgery and medical therapy with metyrapone. Hypoadrenalism can be difficult to diagnose during pregnancy but, once the diagnosis is made, with careful monitoring, dose adjustment as indicated, and parenteral cover for labor, a successful pregnancy should result.
journal_name
Semin Reprod Medjournal_title
Seminars in reproductive medicineauthors
Trainer PJdoi
10.1055/s-2002-36710keywords:
subject
Has Abstractpub_date
2002-11-01 00:00:00pages
375-80issue
4eissn
1526-8004issn
1526-4564journal_volume
20pub_type
杂志文章,评审abstract::In vitro fertilization (IVF) with ovarian stimulation is an effective treatment for couples needing treatment with assisted reproductive technologies (ART) where polycystic ovary syndrome (PCOS) is coexisting. However, it is also associated with an increased risk of ovarian hyperstimulation syndrome. In vitro maturati...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-992932
更新日期:2008-01-01 00:00:00
abstract::The hypothalamus-pituitary-gonadal (HPG) axis is the most critical modulator of reproductive function. Genetic or environmental insults to the HPG axis during developmental windows can persist into adulthood, and processes such as gonadal hormone synthesis, timing of puberty, and fertility can be affected. At the leve...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599083
更新日期:2017-03-01 00:00:00
abstract::The maternal-fetal environment plays an important role in developmental programming of adult disease. Metabolic and hormonal dysfunction during human fetal development accompanies gestational diabetes as a common occurrence in mothers with polycystic ovary syndrome (PCOS), while human fetal androgen excess from congen...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1371087
更新日期:2014-05-01 00:00:00
abstract::Male infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general populatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1694027
更新日期:2019-01-01 00:00:00
abstract::There have been few formal studies of differences in the phenotype of PCOS among women of African-American ancestry. Generally, African-American women tend to have an adverse cardiovascular risk profile when compared with women of other racial groups. The metabolic syndrome is a clinical disorder that identifies indiv...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-992922
更新日期:2008-01-01 00:00:00
abstract::Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) share a common receptor in gonadal cells; however, the presence of these receptors has also been detected in several nongonadal but reproduction-associated tissues of pig, human, and other species. There are no data about the ontogeny of the human LH/hCG ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2001-13907
更新日期:2001-01-01 00:00:00
abstract::Follicular rupture and the transformation of an estrogenic preovulatory follicle into a highly vascularized corpus luteum capable of producing large quantities of progesterone are required for the establishment of pregnancy. These processes are dependent upon the precise remodeling of the ovarian extracellular matrix ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-948552
更新日期:2006-09-01 00:00:00
abstract::As sperm traverse the female tract from vagina to oocyte, they experience a steroid milieu, which due to transcriptional inactivity, they can only respond to via non-genomic signaling. This environment mediates events including capacitation, changes in motility patterns, chemotaxis, and acrosome reaction. Current know...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-973433
更新日期:2007-05-01 00:00:00
abstract::Obesity-related infertility is one of the most common problems of reproductive-age obese women who desire childbearing. The various types of bariatric surgeries have proved effective in controlling excessive weight gain, improving fertility, and preventing certain maternal and fetal complications in these women. This ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1328880
更新日期:2012-12-01 00:00:00
abstract::Controlled ovarian stimulation (COS) is widely used in assisted reproduction techniques (ART). However, hormonal treatment induces endometrial alterations that may alter implantation rates compared with natural cycles. Endometrial alterations have been observed by histological and biochemical techniques. The recent de...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-991043
更新日期:2007-11-01 00:00:00
abstract::The Wnt signaling cascade is critically important in stem cell biology, both in homeostatic maintenance and repair and regeneration of tissues and organs, through their respective somatic stem cells (SSCs). However, aberrant Wnt signaling is associated with a wide array of tumor types and Wnt signaling is important in...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1558404
更新日期:2015-09-01 00:00:00
abstract::During the menstrual cycle, human endometrium undergoes extensive cyclic morphologic and biochemical modifications in preparation for embryo implantation. These processes are highly regulated by ovarian steroids and various locally expressed gene products and involve inflammatory reaction, apoptosis, cell proliferatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1096128
更新日期:2008-11-01 00:00:00
abstract::Gonadotropin-releasing hormone agonist (GnRHa) administration for the induction of oocyte maturation during in vitro fertilization treatment is effective in the prevention of ovarian hyperstimulation syndrome (OHSS). However, some studies have reported a lower ongoing pregnancy rate after GnRHa trigger. The excellent ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1265678
更新日期:2010-11-01 00:00:00
abstract::Intraperitoneal adhesions remain a costly, long-term sequela of abdominal surgery. They cause significant postoperative morbidity and difficult reoperative surgery. Although adhesions have been recognized for more than 250 years, a uniformly effective method of adhesion prevention does not exist. In recent years, rese...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1082391
更新日期:2008-07-01 00:00:00
abstract::Labor initiation is a complex process that remains to be fully elucidated. An area of active research involves the study of the different mechanisms that may lead to successful signaling for parturition. This review focuses on the fetal-derived signals that lead to the initiation of labor. These signals may also play ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-956772
更新日期:2007-01-01 00:00:00
abstract::Since 2004, assisted conception is encompassed by the European Directive on the Quality and Safety of Tissues and Cells (2004/23/EC). The aim of a standard for quality and safety is to minimize risks of errors, contamination, and accidents and to maximize efficiency of use. This article presents a case study of the im...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0032-1311521
更新日期:2012-06-01 00:00:00
abstract::Contraceptive vaginal rings (CVRs) contain sex steroids that diffuse through a plastic polymer ring at a constant rate and are absorbed directly through the vaginal epithelium into the systemic circulation. This delivery system provides many advantages over oral contraceptives (OCs), including avoidance of the first-p...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2001-18646
更新日期:2001-12-01 00:00:00
abstract::This study reviews systematically the effectiveness of management strategies for carriers of a reciprocal translocation involving two chromosomes, ascertained on the basis of recurrent pregnancy loss. Subsequent pregnancy outcomes were tabulated based on whether management was medical or involved in vitro fertilizatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1293201
更新日期:2011-11-01 00:00:00
abstract::During most of gestation, the fetal adrenal gland is almost solely dedicated to the production of dehydroepiandrosterone sulfate (DHEA-S). This specialized ability of the fetal adrenal is unique to primates and occurs because of a specialized fetal zone that composes the bulk of the fetal adrenal gland. Morphologicall...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-861549
更新日期:2004-11-01 00:00:00
abstract::Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe fo...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0030-1248135
更新日期:2010-03-01 00:00:00
abstract::In this article the role of LH receptor gene mutations in patients with aberrant sex differentiation is discussed. In a dominant autosomal familial form of precocious puberty in boys (familial male-limited precocious puberty) LH receptor gene mutations have been identified. These single amino acid changes, mostly foun...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2002-35384
更新日期:2002-08-01 00:00:00
abstract::Asoprisnil (J 867; benzaldehyde, 4-[(11beta, 17beta)-17-methoxy-17-(methoxymethyl)-3-oxoestra-4, 9-dien-11beta-yl]-, 1-oxime) is the prototype of a novel class 11beta-benzaldoxime-substituted selective progesterone receptor modulators (SPRMs) and the first-in-class SPRM to reach an advanced stage of clinical developme...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2005-864034
更新日期:2005-02-01 00:00:00
abstract::Trophoblast cells of the murine placenta are derived from the trophectoderm (TE) cells of the preimplantation embryo. Establishment of the TE cell lineage is the result of a cell segregation event early in blastomere division. Models of cell lineage segregation suggest it is driven by the internalization of spatial in...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570025
更新日期:2016-01-01 00:00:00
abstract::Sperm epigenetic programming is tailored to meet the need of this specialized cell, which include its interaction with the oocyte during fertilization and early embryo development. The unique nature of the sperm epigenome has resulted in multiple studies investigating how perturbations in epigenetics might impact male...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1677047
更新日期:2018-05-01 00:00:00
abstract::HOX genes, encoding homeodomain transcription factors, are dynamically expressed in endometrium, where they are necessary for endometrial growth, differentiation, and implantation. In human endometrium, the expression of HOXA10 and HOXA11 is driven by sex steroids, with peak expression occurring at time of implantatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1242996
更新日期:2010-01-01 00:00:00
abstract::Old World monkeys display physiological responses to steroid hormones that are similar to those of women. In this review, we describe cyclic morphological changes that take place within the uterus of Old World primates during the menstrual cycle. In primates, estrogen stimulates endometrial growth in the follicular ph...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1376357
更新日期:2014-09-01 00:00:00
abstract::Intrauterine insemination (IUI) is a widely used fertility treatment for couples with male and/or non-male factor infertility and is a relatively simple and inexpensive procedure. When used for unexplained infertility, IUI combined with ovarian stimulation increases the pregnancy rates, but evidence does not support t...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1375183
更新日期:2014-07-01 00:00:00
abstract::Reproductive performance may be an important variable in treatment selection for unruptured ectopic pregnancy. The impact of treatment choice on reproductive performance is not known. We searched the literature and then tabulated published case reports on laparoscopic salpingostomy, multiple-dose methotrexate, single-...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-970052
更新日期:2007-03-01 00:00:00
abstract::Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1361822
更新日期:2014-01-01 00:00:00
abstract::In non industrialized countries the incidence of heavy menstrual bleeding (HMB) appears to be similar to that of industrialized countries, although data is scanty. In low-resource settings, women with abnormal uterine bleeding (AUB) often delay seeking medical care because of cultural beliefs that a heavy red menstrua...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287668
更新日期:2011-09-01 00:00:00