Burt, Elizabeth;
(2025)
Variability in Development of Oestrogen Target Organs After Induction of Puberty in Adolescents and Young Adults.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
INTRODUCTION Puberty is a fundamental milestone providing female maturity and involving changes within the female body under the influence of oestradiol. Several pathologies may prevent the onset or completion of spontaneous puberty requiring exogenous oestrogen for maturation of oestrogen target organs including uterus, breast and bone. Optimal uterine development and function is a prerequisite to allow an environment necessary for successful embryo implantation and ongoing pregnancy. The aim of my work is to explore and gain further insight into the variability in oestrogen sensitivity, which factors predict optimal pubertal development, the most effective markers to measure tempo and efficacy of treatment and ultimately how this may affect fertility and pregnancy outcome. I first present the studies assessing the tools to monitor uterine and breast development and then those examining treatment outcomes. ABSTRACT SUMMARY Study 1 A prospective study examining the reproducibility of transabdominal ultrasound and agreement with transvaginal ultrasound and Magnetic Resonance Imaging. Study 2 A prospective study exploring the development of a novel technique using 3D imaging to determine change in breast volume. Study 3 A retrospective cross-sectional study examining uterine size in those who had pubertal induction treatment compared to those who underwent spontaneous puberty. Study 4 A prospective observational study examining the variability of uterine and breast parameters in those undergoing pubertal induction. Study 5 A prospective observational study examining the application of 3D breast imaging in trans females undergoing oestrogen treatment. Study 6 A retrospective cross-sectional study examining the fertility and pregnancy outcomes in women with Turner syndrome and Premature ovarian insufficiency. CONCLUSION These studies have shown that variation in uterine and breast development with oestrogen treatment can be tracked continuously with ultrasound and 3D breast imaging, respectively. Better individualisation of treatment may result in improved outcomes in final volume of oestrogen target organs which may impact future fertility.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Variability in Development of Oestrogen Target Organs After Induction of Puberty in Adolescents and Young Adults |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213965 |
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