Aix-Marseille University, U1251 Marseille Medical Genetics, Marmara Institute, and Department of endocrinology, La Conception Hospital, Assistance publique Hôpitaux de Marseille, Marseille, France.
Aix-Marseille University, U1251 Marseille Medical Genetics, Marmara Institute, and Department of endocrinology, La Conception Hospital, Assistance publique Hôpitaux de Marseille, Marseille, France.
Ann Endocrinol (Paris). 2022 Jun;83(3):188-190. doi: 10.1016/j.ando.2022.04.001. Epub 2022 Apr 17.
Cushing's syndrome is defined by an endogenous or exogenous hypercortisolism. Increased cortisol, as well as increased androgens will have a negative impact on the pulsatile secretion of GnRH, thus leading to an increased risk of infertility. However, pregnancy can occur in a woman with Cushing's syndrome: it is a challenging situation, because of the numerous consequences which can be observed in the mother (increased risk of gestational diabetes, hypertension, eclampsia… in addition to the specific complications of hypercortisolism) and in the fetus (intrauterine growth retardation, prematurity). In contrast, Cushing's syndrome can also appear during pregnancy. It is a very rare situation: the diagnosis is challenging because of the numerous hormonal changes induced by pregnancy on cortisol levels. The objective of this brief review will be to detail the mechanisms of infertility due to hypercortisolism, the diagnostic methods of Cushing's syndrome during pregnancy, the maternal and fetal consequences of hypercortisolism during pregnancy, and finally the potential means of contraception that can be proposed.
库欣综合征的定义为内源性或外源性皮质醇增多症。皮质醇增加以及雄激素增加将对 GnRH 的脉冲分泌产生负面影响，从而导致不孕风险增加。然而，患有库欣综合征的女性可能会怀孕：这是一种具有挑战性的情况，因为母亲（妊娠糖尿病、高血压、子痫前期……除了皮质醇增多症的特定并发症）和胎儿（宫内生长迟缓、早产）中会出现许多并发症。相反，库欣综合征也可能在怀孕期间出现。这是一种非常罕见的情况：由于妊娠对皮质醇水平的影响，导致诊断具有挑战性。本综述的目的将详细描述皮质醇增多症导致不孕的机制、妊娠期间库欣综合征的诊断方法、妊娠期间皮质醇增多症对母婴的影响，以及最终可以提出的避孕方法。
