Reduced FSH and LH action: implications for medically assisted reproduction.
Reduced FSH and LH action: implications for medically assisted reproduction.
复制标题
减少FSH和LH作用：对医学辅助生殖的影响。
DOI：
10.1093/humrep/deab065
复制
发表时间：
2021-05-17
期刊：
影响因子：
--
通讯作者：
Humaidan P
中科院分区：
文献类型：
--
作者：
Bosch E;Alviggi C;Lispi M;Conforti A;Hanyaloglu AC;Chuderland D;Simoni M;Raine-Fenning N;Crépieux P;Kol S;Rochira V;D'Hooghe T;Humaidan P
促黄体生成素（LH）和促卵泡激素（FSH）通过下丘脑、垂体前叶、生殖器官和卵母细胞中复杂的相互作用，在卵泡发育和排卵中发挥互补作用。促性腺激素的产生或作用受损会导致LH和FSH相对或绝对缺乏，从而影响配子发生和性腺类固醇的产生，从而降低生育力。在女性中，LH和FSH缺乏症是一系列具有不同功能或器质性原因的疾病，其特征是低或正常促性腺激素水平和低雌二醇水平。虽然LH和FSH产生减少的原因和影响是众所周知的，但减少作用的概念却很少受到研究人员的关注。最近的证据表明，分子特征，信号以及老化，和一些多态性的负面影响促性腺激素的作用。这些发现具有重要的临床意义，特别是对于医学辅助生殖，其中由上述因素决定的作用减弱，加上GnRH类似物方案引起的内源性促性腺激素产生减少，可能导致对促性腺激素的抵抗，从而导致对卵巢刺激的意外低反应。事实上，LH和FSH作用的重要性已被国际辅助生殖技术监测委员会（ICMART）在其低促性腺激素性性腺功能减退症的定义中强调为性腺衰竭，与由于促性腺激素产生或作用减少而导致的配子发生减少和性腺类固醇产生减少有关。本综述的目的是提供一个概述的决定因素减少FSH和LH的行动，与卵巢刺激反应降低。
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) play complementary roles in follicle development and ovulation via a complex interaction in the hypothalamus, anterior pituitary gland, reproductive organs, and oocytes. Impairment of the production or action of gonadotropins causes relative or absolute LH and FSH deficiency that compromises gametogenesis and gonadal steroid production, thereby reducing fertility. In women, LH and FSH deficiency is a spectrum of conditions with different functional or organic causes that are characterized by low or normal gonadotropin levels and low oestradiol levels. While the causes and effects of reduced LH and FSH production are very well known, the notion of reduced action has received less attention by researchers. Recent evidence shows that molecular characteristics, signalling as well as ageing, and some polymorphisms negatively affect gonadotropin action. These findings have important clinical implications, in particular for medically assisted reproduction in which diminished action determined by the afore-mentioned factors, combined with reduced endogenous gonadotropin production caused by GnRH analogue protocols, may lead to resistance to gonadotropins and, thus, to an unexpected hypo-response to ovarian stimulation. Indeed, the importance of LH and FSH action has been highlighted by the International Committee for Monitoring Assisted Reproduction Technologies (ICMART) in their definition of hypogonadotropic hypogonadism as gonadal failure associated with reduced gametogenesis and gonadal steroid production due to reduced gonadotropin production or action. The aim of this review is to provide an overview of determinants of reduced FSH and LH action that are associated with a reduced response to ovarian stimulation.