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Pulsatile GnRH-Therapie

  • Ludwig WildtEmail author
  • Bettina Böttcher
  • Gerhard Leyendecker
Chapter
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Die hypothalamische Ovarialinsuffizienz stellt ein komplexes Krankheitsbild dar, dessen pathophysiologische Grundlage die Reduktion der hypothalamischen GnRH-Sekretion darstellt. Sie kann durch genetische Defekte, anatomische Läsionen oder funktionelle Faktoren bedingt sein; in Abhängigkeit von ihrem Ausmaß manifestiert sich die Reduktion der GnRH-Sekretion in einem pathophysiologischen Kontinuum, welches sich von der primären über die sekundäre Amenorrhö bis zur Corpus-luteum-Insuffizienz erstrecken kann. Die Therapie der hypothalamischen Amenorrhö besteht bei Frauen mit Kinderwunsch in der pulsatilen Gabe von GnRH, welche die gonadotrope Partialfunktion der Hypophyse auf physiologische Weise wiederherstellt. Bei korrekter Diagnose kann durch diese Therapie der Zyklusablauf vollständig ohne das Risiko der Überstimulation normalisiert und eine Schwangerschaftsrate erzielt werden, die der Schwangerschaftsrate von Frauen mit normalen Zyklus entspricht. Die pulsatile Behandlung mit GnRH stellt deshalb die First-line-Therapie der hypothalamischen Amenorrhö bei Frauen mit Kinderwunsch dar.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  • Ludwig Wildt
    • 1
    Email author
  • Bettina Böttcher
    • 2
  • Gerhard Leyendecker
    • 3
  1. 1.Univ.-Klinik für Gynäkologische Endokrinologie und Medizinische ReproduktionsmedizinUniversität InnsbruckInnsbruckÖsterreich
  2. 2.Univ.-Klinik für Gynäkologische Endokrinologie und ReproduktionsmedizinMedizinische Universität InnsbruckInnsbruckÖsterreich
  3. 3.Kinderwunschzentrum DarmstadtDarmstadtDeutschland

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