title: Treated and untreated women with idiopathic precocious puberty: long-term follow-up and reproductive outcome between the third and fifth decades.
abstract: BACKGROUND
  Central precocious puberty (CPP), treated or untreated, may have implications in adulthood.
  
  
  OBJECTIVE
  To assess the reproductive outcome and social adjustment of former CPP women between the 3rd and 5th decades of life.
  
  
  METHODS
  Cross-sectional study of an historical cohort.
  
  
  METHODS
  Demographic data and gynaecological history of 214 CPP women aged 25-56 years [135 GnRH analogue (GnRHa)-treated, 18 cyproterone acetate (CyA)-treated, 61 untreated] and of 446 controls with normal puberty, matched for age and year of birth, were recorded in a structured interview.
  
  
  RESULTS
  Marital status, education and number of children were similar in CPP women and controls. Clinical hyperandrogenism (acne/hirsutism with oligomenorrhoea) was more frequently reported in CPP women than in controls: GnRHa-treated 29·6% vs 17·4% (P = 0·006), CyA-treated 50% vs 20·4% (P = 0·04), untreated 34·4% vs 17·2% (P = 0·003), with no significant difference between CPP groups. Spontaneous pregnancy was similarly achieved by treated CPP and controls: GnRHa-treated 90·4% vs 93·4%, CyA-treated 86·7% vs 90·2%. Assisted fertilization rate was higher in untreated CPP than treated CPP groups (P = 0·006) and controls (P = 0·03). Untreated CPP was the only parameter associated with clinical hyperandrogenism (OR=2·04, 95% CI, 1·0-4·16, P = 0·07) and fertility problems (OR=3·40, 95% CI, 1·15-10·0, P = 0·047). Course of pregnancy was uneventful in 90·2% of CPP women and 90·9% of controls.
  
  
  CONCLUSIONS
  The increased rate of clinical hyperandrogenism among CPP women implies that the underlying neuroendocrine dysfunction persists into adult life. Pubertal suppression treatment may have a protective effect as fertility problems were more prevalent only among untreated CPP women. Educational achievements and marital status were unaffected by CPP.
authors.affiliation: The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Liora
authors.initials: L
authors.lastname: Lazar
authors.forename: Joseph
authors.initials: J
authors.lastname: Meyerovitch
authors.forename: Liat
authors.initials: L
authors.lastname: de Vries
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
authors.forename: Yael
authors.initials: Y
authors.lastname: Lebenthal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D017373:Cyproterone Acetate / Q000627:therapeutic use; D005260:Female; D005298:Fertility / Q000187:drug effects; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000031:analogs & derivatives; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011629:Puberty, Precocious / Q000188:drug therapy*; D017329:Triptorelin Pamoate / Q000627:therapeutic use
chemical_list: D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D017373:Cyproterone Acetate