Induction of midcycle gonadotropin surge by ovarian steroids in women: a critical evaluation.
Induction of midcycle gonadotropin surge by ovarian steroids in women: a critical evaluation.
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DOI：
10.1210/jcem-57-4-797
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发表时间：
1983-10
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影响因子：
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通讯作者：
James H. Liu;S. Yen
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文献类型：
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作者：
James H. Liu;S. Yen
尽管付出了巨大的努力，雌二醇 (E2) 和孕酮 (P4) 作为触发女性周期中期促性腺激素激增的信号的作用仍未完全确定。在本研究中，通过逐步增量输注 E2 和 P4，在正常女性和性腺功能减退女性（使用 E2 植入物）的卵泡中期阶段实现了 E2 和 P4 水平的排卵前配置。在单独输注 E2 的 96 小时内，卵泡中段和性腺功能减退受试者的 LH 和 FSH 潜伏期分别在（平均值 +/- SE）58 +/- 6.9 和 68.2 +/- 2.6 小时后出现可重复且伴随的激增。对于正常卵泡中期（22.7 +/- 3.9 小时）和性腺功能减退女性（21.8 +/- 2.5 小时），E2 诱导的激增的平均持续时间比自发的周期中期激增（48 小时）短。当开始 E2 输注后 48 小时叠加 P4 输注时，两组女性均实现了接近自发峰值大小的 LH/FSH 峰值。对于性腺功能减退的女性（但不是卵泡中期女性），P4 输注还可将激增发生时间提前 14.7 小时（P 小于 0.001）。我们的数据首次明确证明，持续约 60 小时的 E2 增量构成了启动周期中期促性腺激素激增的卵巢信号，并且排卵前卵泡分泌的 P4 的少量增量需要建立正常的激增规模。因此，P4 虽然对于产生正常的促性腺激素激增至关重要，但它是通过协同 E2 的强制性作用来发挥作用的。
Despite major efforts, the roles of estradiol (E2) and progesterone (P4) as signals for triggering the midcycle gonadotropin surge in women remain incompletely defined. In the present study, a preovulatory configuration of E2 and P4 levels was achieved during the midfollicular phase of normal women and in hypogondal women (with E2 implants) by stepwise incremental infusions of E2 and P4. During the 96 h of E2 infusion alone, reproducible and concomitant surges of LH and FSH occurred after latency periods of (mean +/- SE) 58 +/- 6.9 and 68.2 +/- 2.6 h in midfollicular and hypogonadal subjects, respectively. The mean duration of the E2-induced surge was shorter for both normal midfollicular (22.7 +/- 3.9 h) and hypogonadal women (21.8 +/- 2.5 h) than is the spontaneous midcycle surge (48 h). When P4 infusion was superimposed 48 h after the initiation of E2 infusion, a LH/FSH surge that approximated the dimension of the spontaneous surge was achieved in both groups of women. For the hypogonadal women, but not midfollicular women, P4 infusion also advanced the surge onset by 14.7 h (P less than 0.001). Our data represent the first unequivocal demonstration that incremental E2 sustained for about 60 h constitutes the ovarian signal for initiating the midcycle gonadotropin surge and that a small increment of P4 secreted by the preovulatory follicle is required to establish the normal dimension of the surge. Thus, P4, although essential for creating a normal gonadotropic surge, operates by synergizing the obligatory action of E2.