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  • ACTHAdrenocorticotropic hormone
  • AFC Antral follicle count
  • AIRE Autoimmune regulator gene
  • AISAndrogen insensitivity syndrome
  • AMH Anti-Müllerian hormone
  • APS Autoimmune polyglandular syndrome
  • ArKO Aromatase knockout
  • ART Assisted reproductive therapy
  • BBT Basal body temperature
  • BMD Bone mineral density
  • BMP Bone morphogenic protein
  • cAMP Cyclic adenosine monophosphate
  • CEE Conjugated equine estrogen
  • CRHCorticotropin-releasing hormone
  • DHEAS Dehydroepiandrosterone sulfate
  • DHT Dihydrotestosterone
  • DXA Dual-energy x-ray absorptiometry
  • ERA Estrogen Replacement and Atherosclerosis Trial
  • FGFR1 Fibroblast growth factor receptor 1
  • FMR1 Fragile X gene
  • FSH Follicle-stimulating hormone
  • FXTAS Fragile-X tremor ataxia syndrome
  • GHGrowth hormone
  • GnRHGonadotropin-releasing hormone
  • hCG Human chorionic gonadotropin
  • HDL High-density lipoprotein
  • HERS Heart and Estrogen-Progestin Replacement Study
  • HPO Hypothalamic pituitary ovarian
  • HRT Hormone replacement therapy
  • HSD Hydroxysteroid dehydrogenase
  • HT Hormone therapy
  • IGF-BP Insulin-like growth factor binding protein
  • IUI Intrauterine insemination
  • LDL Low-density lipoprotein
  • LH Luteinizing hormone
  • MBH Medial basal hypothalamus
  • MCR Metabolic clearance rate
  • MMP Matrix metalloproteinase
  • MPAMedroxyprogesterone acetate
  • MT Menopausal transition
  • OMI Oocyte maturation inhibitor
  • PCOS Polycystic ovarian syndrome
  • POF Premature ovarian failure
  • PR Production rate
  • PRL Prolactin
  • SERM Selective estrogen receptor modulator
  • SF-1 Steroidogenic factor-1
  • SHBG Sex hormone–binding globulin
  • SNRI Serotonin-norepinephrine reuptake inhibitor
  • SR Secretion rate
  • SRY Sex-determining region of the Y gene
  • SSRISelective serotonin reuptake inhibitor
  • StAR Steroidogenic acute regulatory protein
  • STRAW Stages of Reproductive Aging Workshop
  • SWAN Study of Women's Health Across the Nation
  • Tg Thyroglobulin
  • TGF Transforming growth factor
  • TPO Thyroid peroxidase
  • TRH Thyrotropin-releasing hormone
  • TSH Thyroid-stimulating hormone
  • VEGF Vascular endothelial growth factor
  • WHI Women's Health Initiative

No gene has yet been identified that generates an ovary from an undifferentiated gonad. It is only in the absence of the sex–determining region of the Y gene (SRY) that the gonad develops into an ovary. (For more details, see the discussion of sexual differentiation in Chapter 14.) Primordial germ cells, which give rise to oocytes or spermatogonia, are first identifiable in the yolk sac endoderm (hindgut) at 3 to 4 weeks' gestation. Once specified, they migrate and proliferate en route through the dorsal mesentery into the gonadal ridge, which is located lateral to the dorsal mesentery of the gut and medial to the mesonephros (Figure 13–1). Studies in mice have suggested that the process of proliferation and navigation to the gonad depends on several genes, including Steel (kit ligand and receptor), β1 integrin, pog (proliferation of germ cells), and many cytokines. Failure of primordial germ cells to develop or migrate into the gonadal ridge results in failure of ovarian development. In contrast, it is suggested that male gonadal development may continue to develop into functional testis despite the absence of germ cells.

Figure 13–1

A. Schematic drawing of a 3-week-old embryo showing the primordial germ cells in the wall of the yolk sac, close to the attachment of the allantois. B. Drawing to show the migrational path of the primordial germ cells along the wall ...

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