Observation of Environment and Reproductive-Endocrine Effects

Study Description:

This study will investigate the relationship between environment, lifestyle, and reproductive function. This will include the study of these factors at enrollment and in response to clinical care for the underlying condition. This study will prospectively follow participants with endocrine reproductive disorders and collect research data, data secondary to clinical care and data regarding internal and external environmental exposures. We hypothesize that dysregulated environment is associated with reproductive and endocrine symptoms and dysfunction, and the clinical phenotype may evolve in response to treatment of the dysfunction.

Objectives:

• To study the hypothesis that external and internal environmental factors are associated with reproductive and endocrine symptoms and dysfunction
• To generate hypothesis for future studies investigating the impact of environment on human health

Endpoints:

Since this is an exploratory and hypothesis generating study there are no pre-defined endpoints of this study.

• INCLUSION CRITERIA:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

• Male or female, referring to sex assigned at birth (cis gender)
• Age >8 years and weight >=12 kg
• A diagnosis of hypogonadism, infertility or other reproductive dysfunction

Some specific diagnoses (as defined in standard guidelines) will include:

• Male or female hypogonadism

• Obesity/metabolic syndrome related to hypogonadism.
• Other reproductive dysfunction (e.g., secondary to endocrine dysfunction, thyroid disorders, Cushing syndrome, pharmacotherapy, etc.)
• Premature Ovarian Insufficiency
• Isolated hypogonadotropic hypogonadism
• Polycystic Ovarian Syndrome
• Delayed Puberty
• Precocious puberty
• Perimenopause and post-menopausal states
• Androgen Excess States (Nonclassic Congenital Adrenal Hyperplasia, Extreme hyperinsulism, Idiopathic etc.)

or

--Exhibiting signs of a diagnosis of hypogonadism, e.g., Bosma arrhinia microphthalmia syndrome (BAMS)

-Ability of participant, legal guardian, or Legally Authorized Representative (LAR) to understand and the willingness to sign a written informed consent document.

Exclusion criteria

An individual who meets any of the following criteria will be excluded from participation in this study:

• A diagnosis of a serious medical disorder such as malignancy or heart disease will be grounds for exclusion at the discretion of the PI or AI.
• Inability to follow up with the research study and/or perform study procedures, at the discretion of the PI or AI.
• Pregnant participants, less than 18 years of age, for their safety, since there is not a trained doctor on the study to give proper medical care to pregnant individuals less than 18 years of age.

Individuals who do not meet the criteria for participation in this study (screen failure) because of an acute, reversible or transient medical reason may be rescreened upon reversal, improvement or stabilization of their clinical status. Participants who develop an acute, reversible or transient medical condition during the study may return upon reversal, improvement or stabilization of their clinical status.

MENOPAUSE COHORT INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria

• Female, referring to sex assigned at birth (cis gender)
• Age 40 - 62 years
• Late perimenopausal or early postmenopausal status, defined by STRAW+10 criteria:
• Late perimenopause (Stage -1): Amenorrhea >=60 days (2 cycles) in 12 months in the absence of other causes
• Early postmenopause (Stage +1a/+1b): Amenorrhea >=12 months but <=2 years since final menstrual period (FMP)
• History of regular menstrual cycles (consistent cycle length of 25 - 35 days) during the reproductive years (approximately 25-40 years of age), without medical intervention
• Ability of participant to understand and the willingness to sign a written informed consent document.

Exclusion criteria

• Previous surgery or procedure that induces amenorrhea or menopause

• Prior hysterectomy (with ovarian conservation)
• Prior bilateral oophorectomy
• Prior endometrial ablation
• Prior chemotherapy or pelvic radiation causing premature ovarian failure (unless age at menopause is clearly documented prior to intervention)
• Current levonorgestrel-releasing intrauterine device (LNG-IUD)
• Diagnosis of reproductive disorder, symptoms of irregular menstrual cycles, or medication or device use (eg, birth control pills) that would prevent the determination of menopausal status.
• Pregnant or breastfeeding
• A diagnosis of a serious medical disorder such as malignancy or heart disease will be grounds for exclusion at the discretion of the PI or AI.
• Inability to follow up with the research study and/or perform study procedures, at the discretion of the PI or AI.

Specific wash-out periods are required for evaluation of diagnosis or for exclusionary medications or supplements.