Progesterone serum levels during the follicular phase of the menstrual cycle originate from the crosstalk between the ovaries and the adrenal cortex
Progesterone serum levels during the follicular phase of the menstrual cycle originate from the crosstalk between the ovaries and the adrenal cortex
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DOI：
10.1093/humrep/17.4.933
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发表时间：
2002-04-01
影响因子：
6.1
通讯作者：
Holzgreve, W
中科院分区：
文献类型：
--
作者：
De Geyter, C;De Geyter, M;Holzgreve, W
背景：排卵前孕酮的升高对排卵具有重要意义，但其调控及其来源存在争议。进行了三个实验，以确定卵泡期孕酮是来自卵巢、肾上腺皮质还是两者兼而有之。方法：第一项研究是在计划辅助生殖的患者中进行的，这些患者在口服避孕药期间或在未经治疗的月经周期的黄体期接受了长效GnRH激动剂。第二项研究也是在GnRH激动剂下调期间进行的：一些孕酮水平升高的患者接受地塞米松(DXM)治疗。其他基础孕酮水平同样升高的患者和孕酮水平较低的患者不接受地塞米松治疗，并作为对照组。最后，对正常周期的志愿者在卵泡早期和晚期以及服用避孕药期间进行了促肾上腺皮质激素(ACTH)测试。结果：在抑制内源性促性腺激素分泌的过程中，ACTH使孕酮水平升高，而GnRH对孕酮水平无影响。地塞米松不能阻止排卵前血清孕酮浓度的升高。ACTH刺激的孕酮和17α-羟孕酮浓度在摄入乙炔雌二醇时显著降低。结论：黄体酮在大多数卵泡期的肾上腺皮质中产生，其功能受一种未知的卵巢因子的调节，而该因子受乙炔雌二醇的抑制。黄体酮的来源在排卵前向卵巢转移。
BACKGROUND: The preovulatory rise of progesterone is important for ovulation, but both its regulation and its origin are controversial. Three experiments were performed to determine whether follicular phase progesterone arises from the ovary, the adrenal cortex or both. METHODS: The first study was performed in patients scheduled for assisted reproduction, who received a long-acting GnRH agonist either during intake of an oral contraceptive or during the luteal phase of an otherwise untreated menstrual cycle. The second study was also performed during down-regulation with a GnRH agonist: some patients with elevated progesterone levels received dexamethasone (DXM). Others with similarly elevated basal progesterone levels and those with low progesterone levels were not treated with DXM and served as controls. Finally, adrenocorticotrophic hormone (ACTH) tests were performed in normocyclic volunteers both during early and late follicular phase and during intake of a contraceptive pill. RESULTS: During the suppression of endogenous gonadotrophin secretion progesterone levels rose after the administration of ACTH, but not of GnRH. DXM did not prevent the preovulatory rise of the serum progesterone concentration. The ACTH-stimulated concentration of progesterone and of 17alpha-hydroxyprogesterone were significantly reduced during intake of ethinyl estradiol. CONCLUSIONS: Progesterone arises in the adrenal cortex during most of the follicular phase, whereby its function is modulated by an unknown ovarian factor, which is suppressed by ethinyl estradiol. The source of progesterone shifts towards the ovaries prior to ovulation.