The hypothalamo-pituitary-gonadal axis (HPG) is activated in healthy girls during infancy; the socalled minipuberty occurring 23 months postnatally. Minipuberty is followed by a relative quiescent period during childhood, during which gonadotropins and gonadal steroids circulates at extremely low concentrations.
At the onset of puberty the HPG axis is reactivated. Evaluation of ovarian function is clinical relevant in girls with pubertal disorders (early and late). However, it is also important to valuate remaining or future ovarian function in girls with sex chromosome disorders (45X), or girls who are exposed to gonadotoxic stimuli (chemotherapy, galactossaemia, etc). Evaluation of ovarian function is determined by measuring of basal levels of gonadal steroids and peptids. Determination of estradiol has proven valuable for decades but requires use of an ultrasensitive RIA or by LCMS/MS. Other ovarian markers include progesterone, inhibin A, inhibin B, AMH and Insl3 which can now be determined by commercially available immunoassays. Levels of these markers before, during and after normal puberty will be presented.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology