受精ジャーナル:体外受精 - 体外受精 - 世界中、生殖医学、遺伝学、幹細胞生物学
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概要

An Update on Factors that Enhance the Chances of Discrimination on Constitutional Delay of Growth and Puberty from Congenital Hypogonadotropic Hypogonadism: Emphasis on Role of INSL3

Kulvinder Kochar Kaur, Gautam Nand K Allahbadia, Mandeep Singh

Delayed Puberty (DP) is practically correlated with the presence of either Constitutional Delay of Growth of Puberty (CDGP), or Congenital Hypogonadotropic Hypogonadism (CHH). Although lots of so called “red flags” are associated with CHH frequently, they usually get sidelined by most physicians. Hence assessment of various markers like Insulin like peptide 3 (INSL3) as well as Inhibin B (INB) has been done in the form of probable markers regarding discrimination of CDGP along with CHH respectively, either in basal state or subsequent to Gonadotropin Releasing Hormone a (GnRHa) stimulation. Insulin like peptide 3(INSL3) represents a product that gets liberated by Leydig cells along with is getting considered in the form of probable marker regarding discrimination of CDGP along with CHH besides the commonly used INB. It is significant to differentiate the 2 conditions as CDGP is correlated with remarkable psychosocial influence on those impacted along with their families besides inspite of tell-tale signs, clinicians fail to diagnose CHH till 18-19 years when changes become irreversible despite treatment fully possible the earlier diagnosis is made with signs of cryptorchidism or microphallus and treatment initiated early. Thus here we have tried to highlight the findings of Abbara, et al, in use of INSL3 as a biomarker in younger boys whereas in adults INB might be the ideal marker in adults. Furthermore, the role of genetic, epigenetic along with environmental factors might control the timing of puberty is getting emphasized in recent studies. Thus for optimization of fertility potential of CHH men with judicious diagnosis and treatment it is significant to increase awareness of physicians to refer a child early when seen with non-descent of testis at birth.