Neuroendocrine Disorders and Reproduction

[Author Photo]Reproductive endocrinology in essence underpins the entire propagation of the population and is a wonderful example of how tightly regulated hormonal systems can control complex processes, in this case human fertility. It is perhaps of no surprise therefore that this process frequently breaks down to such an extent that infertility afflicts approximately 10% of couples of reproductive age. In this series, we have brought together a set of international experts to highlight some of the processes that may interfere with normal fertility, but from an endocrine rather than obstetric/gynecologic viewpoint. Hyperprolactinemia and pituitary tumors are discussed in detail, as are the implications of thyroid dysfunction and glucocorticoid excess. Recent experiments of human nature, notably patients with mutations in the leptin gene and other hypothalamic appetite signals, have emphasized the close relationship between diet, body weight, and reproductive capability. Lack of gonadotropin secretion or aberrant secretion as seen in polycystic ovary syndrome is also discussed in some detail. Finally, advances in molecular biology and pharmacology have led to the development of specific agonists and antagonists of gonadotropin-releasing peptides, and these have found universal use not only in assisted fertility protocols but also in the treatment of other conditions, notably hormone-dependent malignancies.

It has been both a great pleasure and also an educational exercise to have edited this Seminars in Reproductive Medicine issue. I would like to thank all of the contributors for their excellent and timely contributions, and I sincerely hope you enjoy reading the following articles.