Ovarian steroids normally exert homeostatic negative feedback on GnRH release. During sustained exposure to elevated estradiol in the late follicular phase of the reproductive cycle, however, the feedback action of estradiol switches to positive, inducing a surge of GnRH release from the brain, which signals the pituitary LH surge that triggers ovulation. In rodents, this switch appears dependent on a circadian signal that times the surge to a specific time of day (e.g., late afternoon in nocturnal species). Although the precise nature of this daily signal and the mechanism of the switch from negative to positive feedback have remained elusive, work in the past decade has provided much insight into the role of circadian/diurnal and estradiol-dependent signals in GnRH/LH surge regulation and timing. Here we review the current knowledge of the neurobiology of the GnRH surge, in particular the actions of estradiol on GnRH neurons and their synaptic afferents, the regulation of GnRH neurons by fast synaptic transmission mediated by the neurotransmitters gamma-aminobutyric acid and glutamate, and the host of excitatory and inhibitory neuromodulators including kisspeptin, vasoactive intestinal polypeptide, catecholamines, neurokinin B, and RFamide-related peptides, that appear essential for GnRH surge regulation, and ultimately ovulation and fertility.
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http://dx.doi.org/10.1210/er.2009-0023 | DOI Listing |
Anal Chem
January 2025
State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, China.
As the most common and lethal cancer of the female gonads, ovarian cancer (OC) has a grave impact on people's health. OC is asymptomatic, insidious in onset, difficult to diagnose and treat, fast-growing, and easy to metastasize and has poor prognosis and high mortality. How to detect OC as early as possible and treat it without side effects has become a challenging medical problem.
View Article and Find Full Text PDFTransl Pediatr
December 2024
Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, China.
Background: Early menarche is associated with both physical and psychosocial problems. Based on psychological and physical health considerations, for girls with early menarche, some parents and physicians may elect to use gonadotropin-releasing hormone agonists (GnRHa) to delay menstruation. This study aimed to explore the effects of GnRHa treatment on the final height of girls with early menarche and build the models to predict the final adult height (FAH).
View Article and Find Full Text PDFCureus
December 2024
Pathology, New Medical Centre Royal Hospital, Khalifa City, Abu Dhabi, ARE.
Disseminated peritoneal leiomyomatosis (DPL) is a rare entity. It is a benign disease but can mimic disseminated malignancy with extensive disease at multiple sites within the abdominopelvic cavity. The primary contributing factor is postulated to be peritoneal spillage of benign leiomyoma, especially after laparoscopic intervention, although hormonal influences might also play a role.
View Article and Find Full Text PDFArch Gynecol Obstet
January 2025
Gynecology Department, Hospital Clínico San Carlos, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain.
Purpose: Uterine fibroids are the most common pelvic tumors in women, representing the primary indication of hysterectomy. Gonadotropin-releasing hormone (GnRH) antagonists represent a new therapeutic option for premenopausal women. The aim of this review is to evaluate the efficacy and safety of GnRH antagonists in the treatment of uterine fibroids (size reduction and symptom control).
View Article and Find Full Text PDFPLoS One
January 2025
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
The judicious selection of ovulation inhibitors in ovarian stimulation protocols is crucial for the success of assisted reproductive technology (ART). Herein, we investigate the dose-dependent effects of chlormadinone acetate (CMA) and cetrorelix, two distinct ovulation inhibitors, on oocyte maturation in patients with normal ovarian reserve, using univariable and multivariable Poisson regression analyses. Patients undergoing progestin-primed ovarian stimulation (PPOS) with CMA (n = 299) or gonadotropin-releasing hormone antagonist (GnRH-ant) with cetrorelix (n = 605) during their initial in vitro fertilization cycle were enrolled at our center from March 2018 to October 2020 (N = 904).
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