Division of Reproductive Medicine, Department of Obstetrics and Gynecology.
Eur J Endocrinol. 2013 Sep 14;169(4):503-10. doi: 10.1530/EJE-13-0334. Print 2013 Oct.
Little is known about the function of the ovarian neuronal network in humans. In many species, copulation influences endocrinology through this network. As a first step, the possible influence of ovarian mechanical manipulation on pituitary and ovarian hormones was evaluated in polycystic ovarian syndrome (PCOS) and regularly cycling women.
Prospective case-control study (2008-2010).
Ten PCOS women (Rotterdam criteria) undergoing ovulation induction with recombinant-FSH and ten normal ovulatory controls were included in an academic fertility clinic. In the late follicular phase blood was drawn every 10 min for 6 h. After 3 h the ovaries were mechanically manipulated by moving a transvaginal ultrasound probe firmly over each ovary ten times. Main outcome measures were LH and FSH pulsatility and ovarian hormones before and after ovarian manipulation.
All PCOS patients showed an LH decline after the ovarian manipulation (before 13.0 U/l and after 10.4 U/l, P<0.01), probably based on a combination of a longer LH pulse interval and smaller amplitude (P=0.07). The controls showed no LH change (before 9.6 U/l and after 9.3 U/l, P=0.67). None of the ovarian hormones (estradiol, progesterone, anti-Müllerian hormone, inhibin B, androstenedione and testosterone) changed in either group.
Ovarian mechanical manipulation lowers LH secretion immediately and typically only in preovulatory PCOS patients. The immediate LH change after the ovarian manipulation without any accompanying ovarian hormonal changes point to nonhormonal communication from the ovaries to the pituitary. A neuronal pathway from the ovaries communicating to the hypothalamic-pituitary system is the most reasonable explanation.
人类卵巢神经元网络的功能知之甚少。在许多物种中，交配通过该网络影响内分泌学。作为第一步，评估了卵巢机械操作对多囊卵巢综合征（PCOS）和正常排卵女性的垂体和卵巢激素的可能影响。
前瞻性病例对照研究（2008-2010 年）。
10 名接受重组-FSH 诱导排卵的 PCOS 女性（鹿特丹标准）和 10 名正常排卵对照者纳入学术生育诊所。在卵泡晚期，每 10 分钟抽取一次血样，持续 6 小时。3 小时后，通过在阴道超声探头上用力移动每个卵巢 10 次来机械地操作卵巢。主要观察指标为 LH 和 FSH 脉冲性以及卵巢操作前后的卵巢激素。
所有 PCOS 患者在卵巢操作后 LH 下降（操作前 13.0 U/l，操作后 10.4 U/l，P<0.01），可能是由于 LH 脉冲间隔延长和幅度减小（P=0.07）所致。对照组 LH 无变化（操作前 9.6 U/l，操作后 9.3 U/l，P=0.67）。两组的卵巢激素（雌二醇、孕酮、抗苗勒氏管激素、抑制素 B、雄烯二酮和睾酮）均无变化。
卵巢机械操作可立即降低 LH 分泌，仅在预排卵 PCOS 患者中通常如此。卵巢操作后立即发生 LH 变化，而无任何伴随的卵巢激素变化，提示卵巢向垂体传递非激素信号。卵巢与下丘脑-垂体系统之间的神经元通路是最合理的解释。
