LH neither too high nor too low. Society of Gynecological Endocrinology

摘要

Is the theory of "Two cells-two gonadotrophins still valid?" According to current theories of ovarian physiology, FSH plays a crucial role in follicular recruitment, selection and dominance and LH is an important contributor to dominance, final maturation, follicular rupture and ovulation. The challenge came with the commercial availability of recombi-nant gonadotrophin preparations (r-FSH, r-LH) that are given to normally ovulating women who in the majority of cases are under pituitary suppression with GnRH analogues. Nobody knows how much LH activity is necessary for a normal follicular physiology and normal oocyte maturation and ovulation. I agree with what has been published that there is a "threshold of LH" under which ovarian physiology is compromised. But what happens if LH levels are excessively high? It's clear that this situation can affect normal follicular development and we all admit the concept of "LH ceiling" above which follicles enter atresia or are luteinized and oocyte quality is impaired.