The follicle-stimulating hormone threshold level for follicle maturation in superovulated cycles

Lolis, D.; Tsolas, O.; Messinis, Ioannis E.

doi:10.1016/s0015-0282(16)57610-9

Cited by 34 publications

(20 citation statements)

References 16 publications

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“…In contrast, a slight, but extended, elevation of FSH levels during the mid to late follicular phase, effectively preventing the physiological decrease in FSH concentrations, did result in the development of multiple dominant follicles. The present results correspond partly with conclusions drawn from a recent study (33). A single injection of 450 IU FSH to ovulatory women (suffering from unexplained infertility) on cycle day 2 and additional FSH administration (one to three ampules daily) during subsequent days resulted in an increased number of preovulatory follicles dependent on the dose of FSH administered.…”

Section: Discussionsupporting

confidence: 91%

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹

Schipper¹,

Hop²,

Fauser³

1998

The Journal of Clinical Endocrinology & Metabolism

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According to the threshold concept, FSH concentrations need to surpass a distinct level to stimulate ovarian follicle growth. The window concept stresses the significance of a limited duration of elevated FSH levels above the threshold for single dominant follicle selection. The aim of this study was to investigate effects on follicle growth of increased FSH levels, differing in duration and magnitude of elevation, during the follicular phase. Twenty-three normo-ovulatory (cycle length, 26 -31 days), young (age, 20 -31 yr) women volunteered for this study. In all subjects a series of daily transvaginal sonography scans of the ovaries and blood sampling [for FSH and estradiol (E 2 ) determinations] were performed during two consecutive cycles. The first study cycle (control cycle) started 10 days after urinary assessment of the LH surge in the preceding cycle (Day LH ) and was concluded on the day of ovulation assessed by transvaginal sonography scans. The second series of daily monitoring (intervention cycle) started 10 days after Day LH in the control cycle. After randomization, subjects received either 375 IU urinary FSH, sc, as a single injection on Day LHϩ14 (group A; n ϭ 11) or 75 IU daily from Day LHϩ19 until Day LHϩ23 (group B; n ϭ 12).In group A, FSH levels increased on the day after injection to a median concentration of 10.1 IU/L, which was 1.9 times higher (P Ͻ 0.01) than levels on matching days during the control cycle. Concentrations returned to basal levels 3 days after injection. In group B, a moderate elevation of FSH concentrations (15% increase; P Ͻ 0.05) was observed compared to levels during the control cycle. In group A, E 2 concentrations increased (P ϭ 0.03) 1 day after FSH injection and returned to baseline levels within 2 days. In group B, E 2 levels started to increase after the first injection of FSH and remained significantly higher (P Ͻ 0.01) during the following 5 days compared to those on matching days in the control cycle. Compared to matching days in the control cycle an increased number of follicles 8 -10 mm in size was found in group A (P Ͻ 0.01) during the period from Day LHϩ14 until Day LHϩ19 , without an increase in follicles 10 mm or larger thereafter. In contrast, in group B, the numbers of both 8-to 10-mm and 10-mm or larger follicles were higher during the period from Day LHϩ19 until Day LHϩ24 in group B (P ϭ 0.02 and P Ͻ 0.01, respectively).Results from the present study suggest that a brief, but distinct, elevation of FSH levels above the threshold in the early follicular phase does not affect dominant follicle development, although the number of small antral follicles did increase. In contrast, a moderate, but continued, elevation of FSH levels during the mid to late follicular phase (effectively preventing decremental FSH concentrations) does interfere with single dominant follicle selection and induces ongoing growth of multiple follicles. These findings substantiate the FSH window concept and support the idea of enhanced sensitivity of more mature follicles...

show abstract

Section: Discussionsupporting

confidence: 91%

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹

Schipper¹,

Hop²,

Fauser³

1998

The Journal of Clinical Endocrinology & Metabolism

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show abstract

“…Thus, we used the ART index cycle as a form of dynamic testing where hormones were measured after 4 days of gonadotropin ovarian stimulation using a step-down regimen of gonadotropin administration under pituitary suppression. This tapering regimen, where the highest dose of FSH is given on stimulation days 1 and 2 to maximally stimulate follicle recruitment in the primary cohort during the early follicular phase (16,17), has proved to be clinically efficacious (18)(19)(20), and may overcome patient variability in FSH thresholds, metabolic clearance, and ovarian sensitivity to FSH as well as too low residual luteinizing hormone (LH) concentrations existing in some women once pituitary suppression has been achieved (19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Day-5 inhibin B serum concentrations and antral follicle count as predictors of ovarian response and live birth in assisted reproduction cycles stimulated with gonadotropin after pituitary suppression

Peñarrubia

Peralta

Fábregues

et al. 2010

Fertility and Sterility

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“…Follicles recruited by the exogenous administration of FSH in the early follicular phase have their own FSH threshold value for further growth in mid-and late follicular phase (Lolis et al, 1995). If this value is exceeded, follicle recruitment will continue throughout the follicular phase.…”

Section: The Ideal Regimenmentioning

confidence: 99%

Future use of clomiphene in ovarian stimulation. Will clomiphene persist in the 21st century?

Tarlatzis

Grimbizis²

1998

Human Reproduction

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The follicle-stimulating hormone threshold level for follicle maturation in superovulated cycles

Cited by 34 publications

References 16 publications

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹

Day-5 inhibin B serum concentrations and antral follicle count as predictors of ovarian response and live birth in assisted reproduction cycles stimulated with gonadotropin after pituitary suppression

Future use of clomiphene in ovarian stimulation. Will clomiphene persist in the 21st century?

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The follicle-stimulating hormone threshold level for follicle maturation in superovulated cycles

Cited by 34 publications

References 16 publications

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development1

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development1

Day-5 inhibin B serum concentrations and antral follicle count as predictors of ovarian response and live birth in assisted reproduction cycles stimulated with gonadotropin after pituitary suppression

Future use of clomiphene in ovarian stimulation. Will clomiphene persist in the 21st century?

Contact Info

Product

Resources

About

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹

The Follicle-Stimulating Hormone (FSH) Threshold/Window Concept Examined by Different Interventions with Exogenous FSH during the Follicular Phase of the Normal Menstrual Cycle: Duration, Rather Than Magnitude, of FSH Increase Affects Follicle Development¹