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Departments of Obstetrics and Gynecology (K.D., I.M., P.V., A.K., I.E.M.) and Anesthesiology (G.S.), University of Thessalia, 41222 Larissa, Greece; and Clinical Chemistry Laboratory (C.K.), General Hospital of Athens "G. Gennimatas," 11527 Athens, Greece
Address all correspondence and requests for reprints to: Professor I. E. Messinis, Department of Obstetrics and Gynecology, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece. E-mail: messinis{at}med.uth.gr.
Background: The endogenous LH surge is the result of the estrogen-positive feedback effect. However, the factors that are responsible for the termination of LH surge are not known.
Objective: The objective of the study was to investigate the mechanism that terminates the LH surge in women.
Subjects and Methods: Eight normally cycling women (aged 4248 yr) were investigated in two cycles, i.e. cycle 1 (control) and cycle 2. In cycle 2 total abdominal hysterectomy plus bilateral salpingooophorectomy was performed on d 3. In both cycles, estradiol was administered transdermally at the dose of 100 µg on d 3 and 150 µg on d 4 and 5. Blood samples were obtained every 12 h from d 3 to 5 and every 6 h thereafter until d 9.
Results: In both cycles, after suppression of gonadotropins, the women displayed an endogenous LH surge. The time intervals between the commencement of estradiol treatment and the LH surge onset (73.5 ± 1.5 vs. 76.5 ± 2.5 h) and peak LH values (11.4 ± 1.9 vs. 12.4 ± 3.1 IU/liter) were comparable in the two cycles (mean ± SEM). After peaking, LH values decreased gradually in cycle 1, whereas in cycle 2 they remained stable and were higher than the corresponding values in cycle 1 (P < 0.05). Before the LH surge onset, estradiol values showed in both cycles a preovulatory pattern of changes, but starting 24 h after the onset of the LH surge, they were lower in cycle 2 (P < 0.05). Progesterone levels were similar in both cycles until the day of the LH surge onset, but in cycle 2 they declined thereafter and were lower than in cycle 1 (P < 0.05).
Conclusions: It is suggested that ovarian factors rather than exhaustion of pituitary reserves are important for termination of the endogenous LH surge during the normal menstrual cycle.
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