Neuroendocrine axis and reproduction

This PhD thesis is based on the conduct of two lines of research focused on alterations in the hypothalamic-pituitary-gonad axis functioning. The two most common disorders of ovarian function, micropolycystic ovary syndrome (PCOS) and endometriosis, have been identified as models to assess the impact, on the axis, of endogenous and environmental variables, respectively. The first line of research has been focused on the hypothesis that the two main forms of clinical expression of PCOS, the strictly linked to hyperandrogenism and that one associated to insulin resistance, represent distinct disease entities and are, consequently, supported by different pathogenetic mechanisms. This hypothesis finds its origin on the fact that these two forms determine distinguishable endocrine and metabolic profiles. Nevertheless, there are no studies 5 investigating whether the PCOS phenotype differently alters the morphology gonads . On this basis, a clinical observational study has been conducted in PCOS women, aimed at evaluating the relationship between ultrasound pictures of polycystic ovaries and the endocrine-metabolic state of patients. The second line of research stems from the hypothesis of a possible role of environmental pollutants on another of the most common reproductive age pathologies: endometriosis. The disease affects 6- 10% of women and its exact etiology remains unknown. The possible role of toxic agents was proposed back in 1993 by Rier and collaborators and, since then, the interest in the impact on it of contaminants has been high. A systematic review of literature through electronic database was conducted without time restriction in order to analyze the relation between endometriosis and the most common environmental pollutants. The PhD thesis is organized in three chapters. The first two are aimed to report results from the main lines of research. A third chapter regards a parallel research experience that the PhD student started in the last year, during her fellowship at the University “Mangiagalli” of Milan (Italy). Each chapter is further divided in a first part concerning what‟s is known for any single topic and a second one dedicated to related studies done during the PhD.