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Hum. Reprod. Advance Access published online on December 16, 2005
Human Reproduction, doi:10.1093/humrep/dei410
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received December 21, 2004
Revised October 28, 2005
Accepted November 4, 2005

Article

Pituitary-ovarian axis during lactational amenorrhoea. I. Longitudinal assessment of follicular growth, gonadotrophins, sex steroids and inhibin levels before and after recovery of menstrual cyclicity

E.V. Velasquez 1, R.V. Trigo 2, S. Creus 2, S. Campo 2 *, and H.B. Croxatto 1

1 Instituto Chileno de Medicina Reproductiva, José Ramón Gutiérrez 295, Departamento 3, e Instituto Milenio de Biología Fundamental y Aplicada, Santiago, Chile, Argentina
2 Centro de Investigaciones Endocrinológicas, Hospital General de Niños ‘R.Gutiérrez’, Gallo 1330, C1425EFD, Buenos Aires, Argentina

* To whom correspondence should be addressed.
S. Campo, E-mail: scampo{at}cedie.org.ar


  Abstract

BACKGROUND: Comparisons of follicular development and hormonal profile in the same women during and after lactational amenorrhoea (LA) are scarce. We report follicular growth, pituitary and ovarian hormone serum levels in the same women during LA and in follicular phases after resumption of menstrual cyclicity. METHODS: Serum samples were obtained from 10 women during LA between days 60 and 89 post-partum and between days 1 and 4 (early follicular phase; EFP) and 7 and 10 (mid-follicular phase; MFP) of the second and third cycles after LA. RESULTS: The number of follicles >3 mm and diameter of the largest follicle were significantly higher during LA when compared to EFP and MFP. Serum levels of inhibin B were similar in LA and EFP and increased significantly in MFP. Pro-3C was significantly higher in EFP than in LA and MFP. Estradiol was similar during all stages. In comparison with EFP and MFP, LA is associated with higher prolactin levels, normal or slightly elevated gonado-trophins and increased number and size of follicles without a parallel increase in estradiol, inhibin B and Pro-3C. CONCLUSIONS: During LA, there is a profound dissociation between follicular growth and follicular endocrine activity, which suggests an alteration in the stimulus-response relationship at the follicular level.

Keywords: follicular growth/gonadotrophins/inhibins/lactational amenorrhoea/recovered ovarian cyclicity.
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