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Khaled Kabarra Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA

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Pegah Golabi Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA

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Zobair M Younossi Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA
Inova Medicine, Inova Health System, Falls Church, Virginia, USA

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health-related quality of life (HRQoL) burden ( 40 ). It is widely known that patients with CLD suffer from significant impairment of HRQoL as compared to the general population ( 41 ). Fatigue, by far, is the most common symptom reported by patients with

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Sidsel Mathiesen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Kaspar Sørensen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Marianne Ifversen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Casper P Hagen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jørgen Holm Petersen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Klaus Müller Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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of which some were prepubertal at last follow-up), the follow-up times were limited (median age at last follow-up 14–19 years), and importantly, none of the studies included semen quality data. Moreover, no previous studies have investigated pubertal

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M Axelstad Technical University of Denmark, National Food Institute, Kongens Lyngby, Denmark

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U Hass Technical University of Denmark, National Food Institute, Kongens Lyngby, Denmark

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M Scholze Brunel University, Uxbridge, UK

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S Christiansen Technical University of Denmark, National Food Institute, Kongens Lyngby, Denmark

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A Kortenkamp Brunel University, Uxbridge, UK

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J Boberg Technical University of Denmark, National Food Institute, Kongens Lyngby, Denmark

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Introduction Human semen quality is declining in many parts of the world, and this has recently been confirmed by a comprehensive meta-analysis showing declining sperm counts in North America, Europe, Australia and New Zealand over the last

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Jian Gong School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, China

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Yinjuan Lv School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, China

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Yuhao Meng Hubei University of Chinese Medicine, Wuhan, China

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Weiheng Zhang Hubei University of Chinese Medicine, Wuhan, China

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Xiaocui Jiang Hubei University of Chinese Medicine, Wuhan, China

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Min Xiao Laboratory Animal Center, Hubei University of Chinese Medicine, Wuhan, China

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of the male offspring's reproductive organs ( 4 ). In animal models, prenatal stress led to apoptosis of testicular cells and reduced sperm quality and fertility in offspring rats ( 5 ). Maternal stress in sheep during late pregnancy affects sperm

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D Santi Unit of Endocrinology, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Unit of Endocrinology, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

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A R M Granata Unit of Endocrinology, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

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M Simoni Unit of Endocrinology, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Unit of Endocrinology, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

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ART (8) . The outcome of ICSI seems to be influenced by sperm structure and quality (9) . Thus, it seems reasonable that an improvement in sperm quality could effect ICSI outcomes. The empirical administration of follicle stimulating hormone (FSH) to

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Soraya Puglisi Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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Paola Perotti Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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Mattia Barbot Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy

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Paolo Cosio Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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Carla Scaroni Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy

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Antonio Stigliano Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital University of Rome, Rome, Italy

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Pina Lardo Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital University of Rome, Rome, Italy

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Valentina Morelli Endocrinology Unit, Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy

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Elisa Polledri Department of Clinical Sciences and Community Health, Laboratory of Toxicology, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

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Iacopo Chiodini Endocrinology Unit, Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy

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Giuseppe Reimondo Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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Anna Pia Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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Massimo Terzolo Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

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(hypertension, coronary artery disease, heart failure, stroke, thromboembolic events), increased susceptibility to infections and mood disorders. Therefore, CS is characterized by impaired quality of life ( 1 ) and increased mortality, with a reported standard

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Dorte Glintborg Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Magda Lambaa Altinok Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Pernille Ravn Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark

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Kurt Bjerregaard Stage Department of Psychiatry, Odense University Hospital, Odense, Denmark

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Kurt Højlund Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Marianne Andersen Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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obesity predicts the development of type 2 diabetes mellitus in PCOS ( 3 ). Furthermore, obesity predicted poor quality of life in women with PCOS ( 4 ), and the risk of depression was 2–5 times increased in PCOS ( 5 , 6 ). PCOS is characterized by

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Guido Zavatta Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

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Bart L Clarke Mayo Clinic, Rochester, Minnesota, USA

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relatively increased bone density at the lumbar spine, stabilizes hip bone density, and reduces it at the wrist. Producing a PTH analog with finely balanced resorptive and anabolic properties is a significant challenge. Lastly, quality of life (QoL) is

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Milou Cecilia Madsen Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Martin den Heijer Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Claudia Pees Walaeus Library, Leiden University Medical Center, Leiden, the Netherlands

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Nienke R Biermasz Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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Leontine E H Bakker Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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concentrations in serum in the morning on at least two occasions (<10.4 nmol/L) ( 2 , 3 ). Low androgen levels cause morbidity and affect health-related quality of life (HR-QoL) due to infertility, decrease of sexual functions, muscle mass, strength and vitality

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Amir H Zamanipoor Najafabadi Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre and Haga Teaching Hospitals, Leiden and The Hague, The Netherlands

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Merel van der Meulen Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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Ana Luisa Priego Zurita Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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S Faisal Ahmed Chair of Work Package of E-Health & ICT of Endo-ERN, Developmental Endocrinology Research Group, School of Medicine, Dentistry & Nursing, University of Glasgow and Office for Rare Conditions, Royal Hospital for Children & Queen Elizabeth University Hospital, Glasgow, UK

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Wouter R van Furth Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

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Evangelia Charmandari Pediatric Chair Main Thematic Group 6 Pituitary of Endo-ERN, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece

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Olaf Hiort Pediatric Chair and Deputy Coordinator of Endo-ERN, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany

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Alberto M Pereira Adult Chair and Coordinator of Endo-ERN, Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands

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Mehul Dattani London Centre for Pediatric Endocrinology and Diabetes at Great Ormond Street Children's Hospital and University College London Hospitals, London, UK

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Diana Vitali SOD ITALIA (Italian Organization for Septo Optic Dysplasia and other Neuroendocrine Disorders), European Patient Advocacy Group, Rome, Italy

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Johan P de Graaf Dutch Pituitary Foundation, European Patient Advocacy Group, Nijkerk, The Netherlands

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Nienke R Biermasz Adult Chair Main Thematic Group 6 Pituitary of Endo-ERN, Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands

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Introduction The European Reference Network on Rare Endocrine Conditions (Endo-ERN) aims to organize high-quality healthcare throughout Europe for patients with rare endocrine conditions. Through intensive collaboration between its reference

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