Pediatric - adolescent endocrinology and gynecology are entering a new era. Whole exome sequencing approaches with targeted gene panels have become widely available even for prenatal screening, leading to the elucidation of genetic etiologies in endocrine and gynecological diseases and opening the road for genetic precision medicine and the development of specific therapies. The transition from the end of puberty to the attainment of an adult phenotype may be a very long way - up to 10 years or even longer. Meanwhile, conventional approaches to hormone deficiencies are rapidly changing, as are the options for treatment of sexual precocity and infertility.
Commercially available rLH/rFSH preparations in the form of pens - used mainly for fertility induction in women – are now being investigated in hypogonadotropic hypogonadism, aiming to a physiological replacement therapy not only at puberty, but also to the replacement of the missing mini-puberty - crucially important for fertility and the very essence of the male-sex identity itself. Furthermore, they provide an alternative to surgery especially for bilateral cryptorchidism, preserving future fertility.
Aromatase inhibitors (AI) are about to change the treatment landscape of sexual precocity by resolving the issue of compromised growth potential in both sexes in combination with GnRH analogs, growth hormone or even old anabolic solutions such as oxandrolone. Recognizing the raising impact of obesity-induced hypogonadism, their role in restoring testosterone together with gonadotrophins in hypogonadal adolescents and adults is emerging. Along with the quite recent identification and ongoing understanding of the “backdoor” pathway of androgen synthesis, their use in the treatment of exaggerated adrenarche and for restoring fertility issues in women becomes pivotal. Newer applications may involve their concomitant use to optimize testosterone replacement therapy in hypogonadal adolescents and men, as well as their involvement in short protocols for the correction of micropenis at the beginning of puberty.
Advances in the treatment of sexual precocity and infertility welcomes submission of the following article types: General Commentary, Hypothesis and Theory, Mini Review, Opinion, Original Research, Perspective, Policy and Practice Reviews, Review, Systematic Review in order to address the challenges arising in the treatment of sexual precocity and infertility. Below are the proposed (but not limited to) specific topics:
• Infertility
• Precocious puberty
• Exaggerated adrenarche
• Hypogonadism
• Androgen excess
• Aromatase inhibitors
• Induction of Puberty
• Replacement of Puberty
• Induction of fertility
• Genetic precision medicine
Pediatric - adolescent endocrinology and gynecology are entering a new era. Whole exome sequencing approaches with targeted gene panels have become widely available even for prenatal screening, leading to the elucidation of genetic etiologies in endocrine and gynecological diseases and opening the road for genetic precision medicine and the development of specific therapies. The transition from the end of puberty to the attainment of an adult phenotype may be a very long way - up to 10 years or even longer. Meanwhile, conventional approaches to hormone deficiencies are rapidly changing, as are the options for treatment of sexual precocity and infertility.
Commercially available rLH/rFSH preparations in the form of pens - used mainly for fertility induction in women – are now being investigated in hypogonadotropic hypogonadism, aiming to a physiological replacement therapy not only at puberty, but also to the replacement of the missing mini-puberty - crucially important for fertility and the very essence of the male-sex identity itself. Furthermore, they provide an alternative to surgery especially for bilateral cryptorchidism, preserving future fertility.
Aromatase inhibitors (AI) are about to change the treatment landscape of sexual precocity by resolving the issue of compromised growth potential in both sexes in combination with GnRH analogs, growth hormone or even old anabolic solutions such as oxandrolone. Recognizing the raising impact of obesity-induced hypogonadism, their role in restoring testosterone together with gonadotrophins in hypogonadal adolescents and adults is emerging. Along with the quite recent identification and ongoing understanding of the “backdoor” pathway of androgen synthesis, their use in the treatment of exaggerated adrenarche and for restoring fertility issues in women becomes pivotal. Newer applications may involve their concomitant use to optimize testosterone replacement therapy in hypogonadal adolescents and men, as well as their involvement in short protocols for the correction of micropenis at the beginning of puberty.
Advances in the treatment of sexual precocity and infertility welcomes submission of the following article types: General Commentary, Hypothesis and Theory, Mini Review, Opinion, Original Research, Perspective, Policy and Practice Reviews, Review, Systematic Review in order to address the challenges arising in the treatment of sexual precocity and infertility. Below are the proposed (but not limited to) specific topics:
• Infertility
• Precocious puberty
• Exaggerated adrenarche
• Hypogonadism
• Androgen excess
• Aromatase inhibitors
• Induction of Puberty
• Replacement of Puberty
• Induction of fertility
• Genetic precision medicine