Buttram V C
J Reprod Med. 1975 Jan;14(1):21-5.
One cause or anovulation may be an immature hypothalamic-pituitary-ovarian axis. The fact that initial menstrual cycles are usually irregular and often anovulatory implies that a maturation process is taking place in the HPO axis and that cyclic ovulatory menstruation begins only when adequate maturation occurs. Moreover, the external appearance of the ovary of a severely oligomenorrheic or amenorrheic female frequently is similar to that of a prepubertal female--this is, the ovary appears normal in size of slightly smaller, has a smooth, glistening surface without convolutions, and its capsule-like outer surface reveals few, if any, underlying follicles. A reasonable assumption is that there is inadequate gonadotropin stimulation of these ovaries possibly as a result of an immature HPO axis. The studies by radioimmunoassay of FSH and LH levels in prepubertal and pubertal females offer no statistical data by which to measure the maturity of the HPO axis, although consistently low FSH and LH levels may prove meaningful. Studies of FSH and LH in patients exhibiting gonadal dysgenesis neither support or disprove the immature HPO axis theory, but studies of idiopathic sexual precocity tend to support it. Studies using LH-RF in prepubertal and pubertal females indicate a pattern of response which may give useful information in the area.
无排卵的一个原因可能是下丘脑 - 垂体 - 卵巢轴不成熟。最初的月经周期通常不规律且常常无排卵这一事实表明，下丘脑 - 垂体 - 卵巢轴正在经历一个成熟过程，并且只有当充分成熟时才会开始周期性排卵月经。此外，严重月经过少或闭经女性的卵巢外观通常与青春期前女性的卵巢相似——也就是说，卵巢大小正常或略小，表面光滑、有光泽，没有褶皱，其包膜样外表面几乎没有（如果有的话）潜在卵泡。一个合理的假设是，这些卵巢可能由于下丘脑 - 垂体 - 卵巢轴不成熟而受到的促性腺激素刺激不足。通过放射免疫测定青春期前和青春期女性促卵泡生成素（FSH）和促黄体生成素（LH）水平的研究，没有提供可用于衡量下丘脑 - 垂体 - 卵巢轴成熟度的统计数据，尽管促卵泡生成素和促黄体生成素水平持续较低可能有意义。对表现为性腺发育不全患者的促卵泡生成素和促黄体生成素研究既不支持也不反驳下丘脑 - 垂体 - 卵巢轴不成熟理论，但对特发性性早熟的研究倾向于支持这一理论。在青春期前和青春期女性中使用促黄体生成素释放因子（LH - RF）的研究表明了一种反应模式，这可能会在该领域提供有用信息。
