Roles of the cholinergic system and vagal innervation in the regulation of GnRH secretion and ovulation: Experimental evidence.

Reproduction is the biological process that sustains life. It is regulated by a neuro-hormonal mechanism that is synchronized by the interaction among the hypothalamus, hypophysis, and ovaries. Ovulation is regulated by the secretion of the gonadotropin-releasing hormone (GnRH), which stimulates the release of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition to these neuroendocrine signals, other signals originating from the central nervous system, hypophysis, thyroid, adrenal glands, and the ovary itself are also involved. One of the neurotransmission systems involved in the regulation of ovulation is the cholinergic system, which not only participates in the regulation of reproductive functions but also modulates motor coordination, thermoregulation, and cognitive function. In mammals, the vagus nerve is one of the pathways through which acetylcholine reaches the ovary, and this pathway also participates in the regulation of ovulation. However, this regulation depends on the age of the animal (prepubertal or adult) and its endocrine status. The present review analyzes evidence of the roles of the central and peripheral cholinergic system and vagal innervation in the regulation of GnRH secretion and ovulation as well as their roles in the development and persistence of polycystic ovary syndrome (PCOS).