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Hormonal Regulation of the Menstrual Cycle01:22

Hormonal Regulation of the Menstrual Cycle

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
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Ovarian Cycle01:27

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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Hormonal Control of the Ovarian Cycle01:30

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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
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Feedback Regulation of Calcium Concentration01:27

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Calcium is an essential signaling molecule required for various cellular functions. Calcium pumps and ion channels on cell and organellar membranes, such as those on the endoplasmic reticulum (ER), regulate calcium concentrations inside the cell. They remain closed, keeping the cytosolic calcium levels low at a resting state.
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Gonadal and Placental Hormones01:24

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The gonads, namely the testes in males and the ovaries in females, are pivotal in producing gonadal hormones that orchestrate the intricate processes of sexual development and reproduction.
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Proliferative Phase01:20

Proliferative Phase

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The proliferative phase typically occurs after menstruation and lasts between 6 to 13 days in a standard 28-day cycle. This phase involves the reconstruction of the endometrium, guided by estrogen produced by the developing ovarian follicle.
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Recombinant human luteinizing hormone to trigger ovulation: randomized, controlled, dose-finding pilot study in

Roger A Pierson, Olufemi A Olatunbosun, Donna R Chizen

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    Summary

    The minimal effective dose of recombinant human luteinizing hormone (r-hLH) to trigger ovulation in women with anovulatory infertility is 2,750 IU. This dose, when used with recombinant human follicle-stimulating hormone (r-hFSH), offers an effective ovulation induction option.

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    Area of Science:

    • Reproductive Endocrinology
    • Infertility Treatment
    • Hormone Therapy

    Background:

    • WHO Group II anovulatory infertility affects women's reproductive capacity.
    • Ovulation induction (OI) with recombinant human follicle-stimulating hormone (r-hFSH) is a common treatment.
    • The choice of luteinizing hormone (LH) or human chorionic gonadotropin (hCG) for ovulation triggering is critical.

    Purpose of the Study:

    • To compare recombinant human luteinizing hormone (r-hLH) with urine-derived human chorionic gonadotropin (u-hCG) for ovulation triggering.
    • To determine the minimal effective dose of r-hLH in women undergoing OI with r-hFSH.
    • To evaluate ovulation and pregnancy rates in infertile women.

    Main Methods:

    • Phase II, open-label, dose-finding pilot study.
    • Randomization of patients to varying doses of r-hLH (825-22,000 IU) or a fixed dose of u-hCG (5,000 IU).
    • Primary endpoints included ovulation rates and the ratio of ruptured follicles to follicles ≥15 mm; secondary endpoints included monofollicular ovulation and clinical pregnancy rates.

    Main Results:

    • Ovulation was achieved in all patients receiving r-hLH 2,750 IU, 5,500 IU, 11,000 IU, and u-hCG 5,000 IU.
    • The minimal effective dose of r-hLH for ovulation triggering was identified as 2,750 IU.
    • Monofollicular ovulation occurred in 25% of patients; two cases of ovarian hyperstimulation syndrome were reported.

    Conclusions:

    • A dose of 2,750 IU of r-hLH is suggested as the minimal effective dose for ovulation triggering.
    • r-hLH demonstrates efficacy comparable to u-hCG in women with WHO Group II anovulatory infertility undergoing OI.
    • This study provides crucial dose-finding information for r-hLH in infertility treatment.