Barbieri Robert L
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2008 Jul;93(7):2439-46. doi: 10.1210/jc.2008-0752.
Female reproduction spans a developmental life arc from fetal life and childhood, through puberty to the reproductive years, and, finally, ovarian follicle depletion and the onset of menopause.
This invited review highlights a selection of reports from leading journals over the past 2 yr that have significantly advanced our understanding of female reproduction from conception to menopause.
During fetal life, in utero exposures may be important determinants of later pubertal and adult endocrine physiology. Epigenetic mechanisms are likely involved in the fetal programming of adult endocrine function. With regards to the polycystic ovary syndrome, recent clinical trials have confirmed the central role of clomiphene for ovulation induction in women with this disease. In addition, an expert panel has recommended that all women with polycystic ovary syndrome have a glucose tolerance test because of the high prevalence of impaired glucose tolerance in this population. In menopausal women the precise impact of estrogen therapy on cardiovascular biology remains to be delineated fully. Evolving data indicate that when initiated near the onset of menopause, estrogen therapy has fewer cardiovascular risks than when it is administered decades after the menopause.
The essence of reproduction is the successful transmission of germ-line DNA to a succeeding generation. Advances in genetics and endocrinology are converging to advance significantly our understanding of the biology of reproduction and our ability to influence reproductive processes. These advances will translate into new treatments for the prevalent medical problems of reproduction.
女性生殖涵盖了从胎儿期和儿童期开始，经过青春期到生育年龄，最终到卵巢卵泡耗竭和更年期开始的整个发育生命历程。
这篇特邀综述重点介绍了过去两年主要期刊上的一系列报告，这些报告极大地增进了我们对女性从受孕到更年期生殖过程的理解。
在胎儿期，子宫内暴露可能是后期青春期和成年期内分泌生理学的重要决定因素。表观遗传机制可能参与了成年内分泌功能的胎儿编程。关于多囊卵巢综合征，近期临床试验已证实克罗米芬在该疾病女性促排卵中起核心作用。此外，一个专家小组建议所有多囊卵巢综合征女性进行葡萄糖耐量试验，因为该人群糖耐量受损的患病率很高。在绝经后女性中，雌激素疗法对心血管生物学的确切影响仍有待全面阐明。不断发展的数据表明，在绝经开始时附近开始使用雌激素疗法，其心血管风险比在绝经数十年后使用时要低。
生殖的本质是种系DNA成功传递给下一代。遗传学和内分泌学的进展正在融合，以显著增进我们对生殖生物学的理解以及我们影响生殖过程的能力。这些进展将转化为针对常见生殖医学问题的新治疗方法。
