Pulsatile release of LH and oestradiol during the periovulatory period in women

Reproductive ageing in women

The traditional view in respect to female reproduction is that the number of oocytes at birth is fixed and continuously declines towards the point when no more oocytes are available after menopause. In this review we briefly discuss the embryonic development of female germ cells and ovarian follicles. The ontogeny of the hypothalamic-pituitary-gonadal axis is then discussed, with a focus on pubertal transition and normal ovulatory menstrual cycles during female adult life. Biochemical markers of menopausal transition are briefly examined. We also examine the effects of age on female fertility, the contribution of chromosomal abnormalities of the oocyte to the observed decline in female fertility with age and the possible biological basis for the occurrence of such abnormalities. Finally, we consider the effects of maternal age on obstetric complications and perinatal outcome. New data that have the potential to revolutionize our understanding of mammalian oogenesis and follicular formation, and of the female reproductive ageing process, are also briefly considered.

Time series analysis of biologically active luteinizing hormone concentrations during different stages of the menstrual cycle

The biologically active luteinizing hormone concentrations (as measured by testosterone production by mouse Leydig cells in response to LH) were measured in integrated hourly blood samples collected over 24-hour study periods during different stages of the menstrual cycle from a group of regularly cyclic women. Time series analyses were used to analyse the ultradian rhythms in each individual 24-hour LH profile. Fast Fourier transform (FFT) showed the presence of several ultradian rhythms with different periodicities (varying from 4.4 to 22 hours) in most of the LH profiles. In some of the LH profiles several ultradian rhythms appeared to co-exist. The commonest significant rhythm as detected by the FFT had a periodicity of 7-9 hours during both the follicular phase (40% of the subjects) and the mid cycle (50% of the subjects) and a periodicity of 5-7 hours during the luteal phase (44% of the subjects).

Relative changes in LH pulsatility during the menstrual cycle: using data from hypogonadal women as a reference point

The basic premise of this study is that the GnRH-LH pulsatile activity, particularly its frequency characteristics, constitutes, in the absence of any considerable ovarian feedback, the intrinsic rhythm of the hypothalamic-pituitary unit at its maximal rate. Thus, LH pulse attributes determined in postpubertal hypogonadal subjects may be used as a reference in assessing the degree of influence exerted by endocrine factors that modulate GnRH-LH pulses. Accordingly, serum LH levels were determined in samples obtained at 15-min intervals for 24 h in 20 hypogonadal women: 13 postmenopausal women (PMW) and seven women with premature ovarian failure (POF). Similar measurements were performed in 60 normally cycling women: 25 in the early follicular phase (EFP), 13 in the late follicular phase (LFP), seven at midcycle surge (LH surge) and 15 in the midluteal phase (MLP). Significant pulses were identified by the cluster algorithm utilizing factors appropriate for 24 h data series of a sampling frequency of 15-min intervals. The results show a 24-h mean (+/- SE) LH pulse frequency of 78.2 +/- 2.8 and 85.5 +/- 2.4 min per pulse for young (POF) and older (PMW) hypogonadal women, respectively. During the follicular phase of the cycle, the LH pulse frequency is not significantly different from that of hypogonadal women, but there is a significant (P less than 0.05) increase from early to late follicular phases (95.4 +/- 3.3 vs 78.8 +/- 2.2 min per pulse). However, when the sleep periods are excluded from the 24-h data series because of the associated decrease of LH pulse frequency in EFP women, the resulting pulse frequencies are almost identical for EFP, LFP and PMW. An elevation beyond the basic pulse rhythm determined in PMW or POF is not observed in any phase of the menstrual cycle studied, including the midcycle surge. The decrease in LH pulse frequency during the luteal phase of the cycle (151.8 +/- 8.0 min per pulse, P less than 0.001 vs hypogonadal women) beyond the reference pulse frequency of hypogonadal women is unequivocal. By contrast, the pulse amplitude varies markedly among the groups with the largest found in POF (36.6 +/- 4.5 IU/l). It follows, in descending order, PMW (22.7 +/- 3.1 IU/l), midcycle surge (17.3 +/- 2.8 IU/l), MLP women (7.0 +/- 1.3 IU/l) and the EFP (4.9 +/- 0.3 IU/l) and LFP (4.0 +/- 0.4 IU/l).(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence for a specific role of GnRH pulse frequency in the control of the human menstrual cycle

An adequate frequency of gonadotropin-releasing hormone (GnRH) pulses appears to be important for physiological gonadotropin secretion. However, limited information exists on the exact role of this parameter in the regulation of the human menstrual cycle. Thus we studied gonadotropin and gonadal steroid secretion in 32 women with primary hypogonadotropic amenorrhea who received pulsatile GnRH (60 to 120 micrograms/day) at 60- or 120-min intervals for a total of 64 ovulation induction cycles. Ovulation was achieved in 94% of 60-min and in 70% of 120-min cycles P less than 0.05). In the follicular phase of ovulatory cycles, estradiol (E2) levels did not differ among the four groups; however, mean luteinizing hormone (LH) levels were lower (P less than 0.005), and the midcycle LH surge was severely blunted in cycles of subjects receiving 120 micrograms/day (5 micrograms/bolus) GnRH every 120 min compared with subjects receiving the same dose of GnRH per day or per bolus every 60 min. Luteal progesterone (only in 60 micrograms/day GnRH cycles) and E2 levels were lower in 120-min than in 60-min cycles (P less than 0.05). The use of the higher daily GnRH dose (120 micrograms/day) reduced or abolished the frequency-associated hormone level differences. We conclude that a low frequency of pulsatile GnRH in women 1) decreases mean LH levels and blunts the midcycle gonadotropin surge, 2) does not increase follicle-stimulating hormone concentrations, and 3) is associated with a reduced rate of ovulation.

Naloxone reversal of stress-induced suppression of LH release in the common marmoset

There is considerable evidence suggesting that endogenous opioid peptides (EOP) might play a role in the defensive response to stressful stimuli. The stress associated with receipt of aggression from a female conspecific and physical restraint for collection of serial blood samples (at 10-min intervals) resulted in a significant (p less than 0.05) suppression of LH secretion in the oestradiol primed ovariectomized marmoset. Administration of the opioid receptor antagonist, Naloxone (1 mg/kg) immediately before and after receipt of aggression completely prevented the stress-induced decrease in LH release. This suggests that EOP may mediate, at least in part, this stress induced decline in LH release in the marmoset.

Effect of preovulatory estradiol concentrations on luteinizing hormone diurnal secretory patterns: a hypothesis for the timing of the luteinizing hormone surge

The effect of preovulatory estradiol concentrations on 24-hour patterns of luteinizing hormone secretion was studied in six women with normal menstrual cycles. Blood samples were collected every 15 minutes for 24 hours before and after 7 days of estradiol benzoate administration, which achieved mean (+/- SE) estradiol concentrations of 424 +/- 54 pg/ml. The luteinizing hormone pulse frequency decreased significantly during sleeping hours both before (p less than 0.05) and after (p less than 0.005) estradiol benzoate administration. After estradiol benzoate, there also was diurnal variation in overall mean luteinizing hormone concentrations, which markedly increased secretion in the morning hours. The diurnal changes in luteinizing hormone secretion varied inversely with those of prolactin. These findings are consonant with the observation that the onset of the preovulatory luteinizing hormone surge in women occurs most frequently in the early morning hours.

Oestradiol assays: applications and guidelines for the provision of a clinical biochemistry service

This paper reports on the provision of a clinical biochemistry service for serum oestradiol. The pathophysiology and recognised applications of oestradiol assays are discussed and the current availability of assay reagents and methodologies reviewed. Data are presented on the analytical performance of assays for serum oestradiol in the UK External Quality Assessment Scheme (UKEQAS) and general guidance is offered to laboratories providing a diagnostic service for this analyte.

Is changing hypothalamic activity important for control of ovulation?

The activity of the hypothalamic gonadotrophin releasing hormone pulse generator in women with regular ovulatory and anovulatory menstrual cycles was assessed to see whether changes therein are important determinants of normal and impaired ovarian function. Endogenous gonadotrophin releasing hormone secretion was inferred by measurement of the pituitary luteinising hormone response by characterisation of pulsatile luteinising hormone release over eight hours on three occasions during the course of follicular development and once during the luteal stage of the same cycles. In 13 ovulatory cycles (serum progesterone concentration greater than 25 nmol/l) confirmed by ovarian ultrasonography a pronounced variability in luteinising hormone pulse patterns among subjects was compatible with ovulation. In the luteal stage of ovulatory cycles the luteinising hormone interpeak interval (85 min, range 42-125) was significantly longer than that during the early follicular (64 min, 40-103), mid-follicular (62 min, 37-107), and late follicular (59 min, 39-80) stages of the same cycles. Thus in ovulatory cycles no increase in frequency of the gonadotrophin releasing hormone pulse generator was detected during follicular development, though this activity decreased in the luteal stage. In five late follicular stage studies in which part of the preovulatory luteinising hormone surge was captured no change in pulse frequency of luteinising hormone was detected compared with the mid-follicular stage of the same cycles or when compared with the late follicular stage of other cycles when no luteinising hormone surge was captured. Though mean luteinising hormone concentrations in luteinising hormone surge series (36 IU/l) were high, the amplitude of luteinising hormone pulses (165%) was only slightly greater than during non-surge late follicular stage studies (145%). Hence no change in hypothalamic gonadotrophin releasing hormone activity is required to generate the preovulatory discharge of luteinising hormone in man, which occurs as a result of the sensitising action of rising oestradiol concentrations on pituitary responsiveness to the same hypothalamic input signal. Luteinising hormone pulse frequency, peak amplitude, and mean serum luteinising hormone concentrations in seven anovulatory cycles (progesterone concentration less than 10 nmol/l) were not different from those at comparable stages of ovulatory cycles. These data suggest that the primary abnormality in this group of regularly menstruating anovulatory women lies in the ovary rather than in the hypothalamic control of the anterior pituitary.

Pulsatility of reproductive hormones: physiological basis and clinical implications

The secretion of LHRH from the median eminence, into hypophyseal portal blood provides a signal whereby the central nervous system interfaces with the endocrine system. The pulsatile nature of this system originates from phasic neural signals and, except in extreme cases where pulses are eliminated by the pituitary action of steroids, pulse frequency is determined by LHRH secretion. Steroidal feedback and other extrinsic influences that affect pulse frequency act via neural afferents to the LHRH neurons. Amplitude regulation may be by way of steroidal influence at the level of the pituitary gland, or indirectly via changes in LHRH pulse frequency. In this chapter, we have attempted to outline our current knowledge of factors regulating LHRH pulsatility and how this is transmitted into pulsatile gonadotrophin secretion. Regarding PRL secretion, we have outlined evidence that pulsatility is inherent in the lactotrophs, requiring no hypothalamic input. The possible roles of PRL releasing factors in circumstances like suckling and stress and of PRL inhibiting factors have been discussed with reference to the pulsatile nature of PRL secretion.