Porcine Mullerian Inhibiting Substance/Anti Mullerian Hormone ELISA Kit

Zusammenfassung Wir stimmen dem in der Leitlinie genannten starken Konsens fur Ma ss nahmen der Reproduktionsmedizin als wichtige Option zur Erfullung des Kinderwunsches bei trans Personen uneingeschrankt zu. Informationen uber diese Ma ss nahmen mussen Bestandteil von Behandlungen von trans Personen sein. Die geschlechtsangleichende Hormontherapie bei Mann-zu-Frau trans Personen hat jedoch einen negativen Einflu ss auf die Spermatogenese. Der Erfolg der Fertiltatsprotektion bei Mann-zu-Frau trans Personen hangt stark von Qualitat und Quantitat der Spermien bzw. der spermatogonialen Stammzellen ab. Daher sollte die Beratung vor der geschlechtsangleichenden Hormontherapie stattfinden. Zu Beginn sollten eine ausfuhrliche Anamnese, eine korperliche Untersuchung, eine Untersuchung von Serumhormonen (LH, FSH, Testosteron, ostradiol, AMH, Inhibin B) und ggf. eine Untersuchung des Ejakulats erfolgen. Zu den etablierten Methoden der Fertilitatsprotektion zahlen Kryokonservierung von Spermien nach Ejakulation, Kryokonservierung von Spermien nach mikrochirurgischer testikularer Spermienextraktion (mTESE) oder Spermienaspiration aus dem Nebenhoden (MESA) oder Kryokonservierung von spermatogonialen Stammzellen. Letztere sind auch moglich, wenn die geschlechtsangleichende Hormontherapie vor Beginn der Pubertat begonnen wird. Dies ist derzeit noch experimentell. Kryokonservierte Spermien konnen dazu verwendet werden, im Rahmen einer In-vitro-Fertilisation (IVF) und intrazytoplasmatischen Spermieninjektion (ICSI) mit Frauen eigene Kinder zu zeugen. Leihmutterschaft oder Eizellenspende ist in Deutschland derzeit nicht moglich. Wir wollen betonen, dass das Gesprach uber fertilitatsprotektive Ma ss nahmen so fruh wie moglich stattfinden muss, um den Erfolg zu garantieren und Absprachen zwischen den medizinischen Diszplinen zu ermoglichen. Das Ziel sind individuelle Losungen, die fur trans Personen finanzierbar, gangbar und operativ mit einfachen Mitteln zu erreichen sind. Abstract The desire to have children in trans persons is supported in the new guideline and we wholeheartedly agree with this decision to support trans women in the ability to choose between the different procedures of fertility protection necessary to achieve that. We strongly suggest that counselling with regard to the various possibilities has to be part of the treatment routine for trans persons. Gender-affirming hormone therapy in trans women, however, has a negative effect on spermatogenesis. The success of fertility protection in general is directly linked to the quality and quantity of sperm or spermatogonial stem cells. Hence, information and counselling should take place before hormone therapy has started. Before possible fertility protection methods can be offered, the medical history, clinical examination, examination of sex hormones (LH, FSH, testosterone, estradiol, AMH, inhibin B) and if possible examination of ejaculate should be performed. Established methods of fertility protection are cryopreservation of sperm after ejaculation, cryopreservation of sperm after micro-surgical testicular sperm extraction (mTESE), sperm aspiration out of the epididymis (MESA), or cryopreservation of spermatogonial stem cells. The latter could also be an option for trans women who begin hormone therapy before puberty; this however is still experimental. In vitro fertilization (IVF) or intracytoplasmatic sperm injection (ICSI) using cryopreserved sperm can then be performed in order for female partners to have own children. Surrogacy or egg donations are presently not possible in Germany. We want to emphasize that counselling with regard to different methods of fertility protection has to happen as early as possible in the gender-affirming process in order to increase the success rate and enable the coordination of different medical disciplines. Individual solutions have to be found that are financially viable, where standardized operations can be performed, and that can be achieved easily without disturbing the hormone therapy.

Objective: Preeclampsia is a common disorder of pregnancy, causing significant morbidity and mortality for mothers and infants. Several molecules, including glycosylated fibronectin (GlyFn), the inhibin-related proteins, anti-mullerian hormone (AMH), and the insulin-like growth factor axis, are altered in maternal plasma in the setting of preeclampsia; however, these molecules have not been previously measured in cord blood of infants born to mothers with preeclampsia, which may represent changes in fetal physiology. We evaluated potential biomarkers of preeclampsia in umbilical cord blood to fill the gap in knowledge. Methods: This is a case-control study of 196 neonates born at a tertiary teaching hospital in Boston from 2010-2017. Forty-nine neonates born to mothers with preeclampsia were matched 1:3 by gestational age, sex, and birth weight z-score with 147 controls. Eleven analytes were measured in cord blood by enzyme-linked immunosorbent assay. Binary logistic regression analyses were performed to evaluate associations between preeclampsia and analytes. Results: Mean cord blood levels of GlyFn and total inhibin were significantly lower in neonates born to mothers with preeclampsia compared to controls, and AMH levels were significantly higher in males born to mothers with preeclampsia than male controls. Associations remained significant after controlling for maternal and neonatal characteristics. Conclusion: Cord blood levels of GlyFn and inhibin are decreased and AMH (male) levels are increased in infants of preeclamptic mothers, which is opposite the pattern these biomarkers show in serum of mothers with preeclampsia. These molecules may be important in the pathophysiology and long-term effects of preeclampsia on the developing fetus.