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Human Reproduction, Vol. 10, No. 12, pp. 3117-3120, 1995
© 1995 European Society of Human Reproduction and Embryology

research-article

A reappraisal of the feedback effects of oestradiol uppm luteinizing hormone surge

D. Levran, I. Ben-Shlomo, A. Luski1, Z. Ben-Rafael, J. Dor, S. Mashiach and D.S. Seidman2

Department of Obstetrics and Gynecology 1Department of Clinical Epidemiology, Chaim Sheba Medical Center Tel Hashomer 52621, Sackler School of Medicine, Tel Aviv University, Israel

Correspondence: 2To whom correspondence should be addressed

The objective of this study was to assess the temporal relationships of serum oestradiol and luteinizing hormone (LH) with regard to the feedback mechanism leading to the LH surge. Daily measurements of oestradiol, LH and follicle stimulating hormone were made in 65 women with ovarian failure undergoing an evaluation of endometrial response to oral cycle stimulation. Patients received incremental oral oestradiol valerate for varying durations at the in-vitro fertilization unit of the Sheba Medical Center, Tel Hashomer, Israel. The treatment protocol involved the administration of daily oestradiol valerate, starting with 1 mg/day, followed by a daily increment of 1 mg for a total of 4, 6 and 8 days. After the last day, a daily maintenance dose of 2 mg was continued. Serum oestradiol concentrations correlated with the dose of oral oestradiol valerate. Peak oestradiol concentrations (mean ± SEM) were 572 ± 60, 721 ± 42 and 797 ± 53 pg/ml for 4, 6 and 8 days of oestradiol valerate administration respectively. Serum LH, after an initial suppression, peaked 2 days after maximal oestradiol valerate dose and 1 day after peak serum oestradiol. The magnitude of the LH peak was proportional to the duration of incremental oestradiol valerate treatment. In conclusion, the LH surge is temporally related to the cessation of serum oestradiol increase. Consequently, the occurrence of this surge can be explained by a simple negative feedback inhibition of pituitary LH release rather than by a dual negative/positive mechanism.

Key words: luteinizing/hormone/feedback/mechanism/LH/surge/oestradiol


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