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Anne Bachelot, Zeina Chakhtoura, Geneviève Plu-Bureau, Mathieu Coudert, Christiane Coussieu, Yasmina Badachi, Jérome Dulon, Beny Charbit and Philippe Touraine

The journal apologises for an error in the Funding section of the above article published in the October issue of the journal (vol 167 issue 4 pages 499–505). The corrected section is published in full below:

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Anne Bachelot, Zeina Chakhtoura, Geneviève Plu-Bureau, Mathieu Coudert, Christiane Coussieu, Yasmina Badachi, Jérome Dulon, Beny Charbit and Philippe Touraine

Objective

Women with classical congenital adrenal hyperplasia (CAH) exhibit reduced fertility due to several factors including anovulation. This has been attributed to a disturbed gonadotropic axis as in polycystic ovary syndrome (PCOS), but there is no precise evaluation. Our aim was to evaluate the gonadotropic axis and LH pulsatility patterns and to determine factor(s) that could account for the potential abnormality of LH pulsatility.

Design

Case/control study.

Methods

Sixteen CAH women (11 with the salt-wasting form and five with the simple virilizing form), aged from 18 to 40 years, and 16 age-matched women, with regular menstrual cycles (28±3 days), were included. LH pulse patterns over 6 h were determined in patients and controls.

Results

No differences were observed between patients and controls in terms of mean LH levels, LH pulse amplitude, or LH frequency. In CAH patients, LH pulsatility patterns were heterogeneous, leading us to perform a clustering analysis of LH data, resulting in a two-cluster partition. Patients in cluster 1 had similar LH pulsatility patterns to the controls. Patients in cluster 2 had: lower LH pulse amplitude and frequency and presented menstrual cycle disturbances more frequently; higher 17-OH progesterone, testosterone, progesterone, and androstenedione levels; and lower FSH levels.

Conclusions

LH pulsatility may be normal in CAH women well controlled by hormonal treatment. Undertreatment is responsible for hypogonadotropic hypogonadism, with low LH pulse levels and frequency, but not PCOS. Suppression of progesterone and androgen concentrations during the follicular phase of the menstrual cycle should be a major objective in these patients.

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Anne Bachelot, Agnès Rouxel, Nathalie Massin, Jérome Dulon, Carine Courtillot, Christine Matuchansky, Yasmina Badachi, Anne Fortin, Bernard Paniel, Fabrice Lecuru, Marie-Aude Lefrère-Belda, Elisabeth Constancis, Elisabeth Thibault, Géri Meduri, Anne Guiochon-Mantel, Micheline Misrahi, Frédérique Kuttenn, Philippe Touraine and on behalf of the POF-GIS Study Group

Objective

Premature ovarian failure (POF) encompasses a heterogeneous spectrum of conditions, with phenotypic variability among patients. The etiology of POF remains unknown in most cases. We performed a global phenotyping of POF women with the aim of better orienting attempts at an etiological diagnosis.

Design and methods

We performed a mixed retrospective and prospective study of clinical, biological, histological, morphological, and genetic data relating to 357 consecutive POF patients between 1997 and 2008. The study was conducted at a reproductive endocrinology referral center.

Results

Seventy-six percent of the patients presented with normal puberty and secondary amenorrhea. Family history was present in 14% of the patients, clinical and/or biological autoimmunity in 14.3%. Fifty-six women had a fluctuating form of POF. The presence of follicles was suggested at ultrasonography in 50% of the patients, and observed in 29% at histology; the negative predictive value of the presence of follicles at ultrasonography was 77%. Bone mineral density alterations were found in 58% of the women. Eight patients had X chromosomal abnormalities other than Turner's syndrome, eight other patients evidenced FMR1 pre-mutation. Two other patients had autoimmune polyendocrine syndrome type 2 and 1.

Conclusion

A genetic cause of POF was identified in 25 patients, i.e. 7% of the whole cohort. POF etiology remains most often undiscovered. Novel strategies of POF phenotyping are in such content mandatory to improve the rate of POF patients for whom etiology is identified.