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Pulsatile GnRH-Therapie

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Reproduktionsmedizin

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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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Authors and Affiliations

  1. Univ.-Klinik für Gynäkologische Endokrinologie und Medizinische Reproduktionsmedizin, Universität Innsbruck, Innsbruck, Österreich

    Ludwig Wildt

  2. Univ.-Klinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich

    Bettina Böttcher

  3. Kinderwunschzentrum Darmstadt, Darmstadt, Deutschland

    Gerhard Leyendecker

Authors
  1. Ludwig Wildt
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  2. Bettina Böttcher
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  3. Gerhard Leyendecker
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Correspondence to Ludwig Wildt .

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Editors and Affiliations

  1. Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie Hamburg GmbH, amedes experts, Hamburg, Germany

    Klaus Diedrich

  2. SYNLAB Holding Deutschland GmbH, Augsburg, Hamburg, Germany

    Michael Ludwig

  3. Sektion für gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Schleswig-Holstein – Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Georg Griesinger

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Wildt, L., Böttcher, B., Leyendecker, G. (2019). Pulsatile GnRH-Therapie. In: Diedrich, K., Ludwig, M., Griesinger, G. (eds) Reproduktionsmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55601-6_16-1

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  • DOI: https://doi.org/10.1007/978-3-662-55601-6_16-1

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  • Print ISBN: 978-3-662-55601-6

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