THE SEQUENCE OF PITUITARY RESPONSES TO SYNTHETIC LUTEINIZING HORMONE RELEASING HORMONE (LH-RH) THROUGHOUT THE NORMAL MENSTRUAL CYCLE

Abstract

ABSTRACT Thirty-one ovulatory women between 20 and 33 years of age were given 150 μg of synthetic LH-RH during different phases of the menstrual cycle. Five patients were studied during the early follicular phase (days 4–7); 10 patients during the late follicular phase (days 9–12); 6 patients during the "LH Surge"; 5 patients during the early luteal phase (days 14–16); 3 patients during mid-luteal phase (days 17–21); and 2 patients during late luteal phase (days 22–27). Oestrogen, progesterone, FSH and LH levels were determined from 30 min prior to LH-RH administration to 90 min thereafter in all cases. LH response to LH-RH increased progressively during the follicular phase. Enhanced pituitary responsiveness to LH-RH occurred at mid-cycle for both LH and FSH and maximum LH responses occurred during the "LH Surge" and early luteal phase. LH responses during the mid and late luteal phases were similar to late follicular phase responses. There were no significant differences between FSH responses during the early follicular, late follicular, mid-luteal and late luteal phases. Maximum pituitary responsiveness appears to occur in a gonadal steroid milieu of high oestrogen levels in association with rising but low progesterone levels. Progesterone or a crucial oestrogen: progesterone ratio may in fact potentiate pituitary release of LH during the early stages of corpus luteum formation. Pituitary responsiveness to LH-RH correlates positively with basal LH and oestrogen levels during the menstrual cycle and with the oestrogen:progesterone ratio during the luteal phase.