Title Endokrinološke bolesti i neplodnost Title (english) Endocrine disorders and infertility Author Petra Terzić Mentor Lana Škrgatić (mentor)Committee member Marina Šprem-Goldštajn (predsjednik povjerenstva)Committee member Dinka Pavičić Baldani (član povjerenstva)Committee member Lana Škrgatić (član povjerenstva)Granter University of Zagreb Defense date and country 2024-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Neplodnost je značajan javnozdravstveni problem s kojim se susreće oko 20% parova diljem svijeta. Uzroci neplodnosti su brojni i raznovrsni, a među njima poseban položaj zauzimaju endokrinološke bolesti. Poremećaj lučenja hormona važnih za reprodukciju te posljedična neplodnost može se dogoditi na razini hipotalamusa i hipofize kao posljedica pretilosti, stresa, preniske tjelesne težine, Sheehanovog sindroma ili stanja hiperprolaktinemije. Nadalje, poremećaji rada štitnjače poput hipertireoze i hipotireoze uvelike utječu na plodnost žena, dok njihov utjecaj na mušku plodnost nije u potpunosti jasan. Timus također utječe na plodnost, a najčešće opisana patologija je mutacija AIRE gena koja dovodi do autoimunog poliglandularnog sindroma 1 (APS 1). Od bolesti gušterače ističu se šećerna bolest tipa 1 i 2 koje različitim mehanizmima utječu na plodnost kako muškaraca, tako i žena. Pravovremena dijagnoza i valjana kontrola glikemije izrazito su važni u ovih bolesnika kako bi se spriječio negativan utjecaj bolesti na reproduktivno zdravlje. Kod žena je najčešći uzrok neplodnosti anovulacija, a najčešći uzrok anovulacijskih ciklusa je sindrom policističnih jajnika (PCOS). Primarna ovarijska insuficijencija rijetko je stanje koje pogađa tek 1% žena, ali ipak se treba uzeti u obzir prilikom obrade neplodnosti. Po novijim istraživanjima, muškarci su odgovorni za 40 do 50% neplodnosti parova, a uzroci mogu biti različiti. Primarna testikularna insuficijencija odnosi se na stanja u kojima testisi ne proizvode dovoljno testosterona i spermija, dok je sekundarna testikularna insuficijencjia stanje u kojem postoji patologija hipotalamusa ili hipofize te je posljedično smanjena sinteza testosterona. Prilikom obrade neplodnosti parova, važno je isključiti poremećaje ili kronične bolesti koje su povezane s neplodnošću. Ukoliko se detektiraju, potrebno ih je korigirati prije liječenja metodama potpomognute oplodnje (MPO).
Abstract (english) Infertility is a significant public health problem that affects about 20% of couples worldwide. The causes of infertility are numerous and diverse, with endocrine disorders holding a unique position among them. Disruption in secretion of reproductive hormones and consequent infertility may occur at hypothalamus and pituitary gland level because of obesity, stress, low body weight, Sheehan syndrome or hyperprolactinemia. Furthermore, disorders like hyper or hypothyroidism greatly affect female fertility, whereas the effect on male fertility is not fully understood. The thymus may also affect fertility, with the most commonly described pathology being mutations in the AIRE gene leading to autoimmune polyglandular syndrome 1 (APS 1). Pancreas diseases, such as diabetes mellitus type 1 and 2, stand out as conditions that affect fertility in both men and women through various mechanisms. Prompt diagnosis and proper glycemic control are extremely important in these patients to prevent negative impact of the disease on reproductive health. The most common cause of infertility in women is anovulation, and the main cause of anovulatory cycles is polycystic ovary syndrome (PCOS). Primary ovarian insufficiency is a rare condition that only affects 1% of women, however, it should be considered when evaluating couple’s infertility. New research suggest that men are responsible for 40 to 50% of couples’ infertility, and the causes are diverse. Primary testicular insufficiency refers to conditions in which the testicles do not produce enough testosterone and sperm, while secondary testicular insufficiency is a condition in which there is a pathology of the hypothalamus or pituitary gland and, as a result, testosterone synthesis is reduced. When assessing infertility in couples, it is important to rule out disorders or chronic diseases associated with infertility. If detected, they need to be corrected before proceeding with assisted reproductive technologies (ART).
Keywords
dijagnostika
endokrinološke bolesti
liječenje
neplodnost
Keywords (english)
diagnosis
endocrine disorders
infertility
treatment
Language croatian URN:NBN urn:nbn:hr:105:677759 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-06-27 14:39:12
