Klein N A, Battaglia D E, Clifton D K, Bremner W J, Soules M R
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle 98105, USA.
J Soc Gynecol Investig. 1996 Jan-Feb;3(1):27-32. doi: 10.1016/1071-5576(95)00040-2.
Women of advanced reproductive age are known to demonstrate subtle FSH elevations (monotropic FSH rise) while still retaining ovulatory function. The purpose of this study was to investigate the hypothesis that the physiologic basis for the monotropic FSH rise is an alteration in the secretion pattern of the GnRH pulse generator.
The subjects were 11 normal women age 40-45 years who underwent 24 hours of frequent blood sampling in the follicular (EF) and/or midluteal (ML) phases of spontaneous menstrual cycles. The controls were 11 normal women age 20-25 years. The respective gonadotropin secretion patterns were analyzed for LH pulse frequency, mean LH and FSH levels, and LH pulse amplitude.
There were no differences between the groups for estradiol (E2) and progesterone when the respective cycle phases were compared. The 24-hour mean FSH level was significantly increased in the older women in both the EF and ML phases. There were no differences between the groups in either cycle phase for LH pulse frequency, LH pulse amplitude, and mean LH levels.
The results lend no support to the hypothesis that a slowing or other alteration of the GnRH pulse generator is the basis for the monotropic FSH rise in older ovulatory women. Other possibilities include the dynamics of E2 secretion or changes in FSH-modulating peptides (i.e., inhibin) in these women.
已知高龄育龄女性会出现促卵泡激素（FSH）轻微升高（单向性FSH升高），但仍保留排卵功能。本研究的目的是探讨单向性FSH升高的生理基础是促性腺激素释放激素（GnRH）脉冲发生器分泌模式改变这一假说。
研究对象为11名年龄在40 - 45岁的正常女性，她们在自然月经周期的卵泡期（EF）和/或黄体中期（ML）接受了24小时的频繁采血。对照组为11名年龄在20 - 25岁的正常女性。分析了各自的促性腺激素分泌模式，包括促黄体生成素（LH）脉冲频率、平均LH和FSH水平以及LH脉冲幅度。
在比较各自的周期阶段时，两组之间的雌二醇（E2）和孕酮无差异。在EF期和ML期，老年女性的24小时平均FSH水平均显著升高。在两个周期阶段，两组之间的LH脉冲频率、LH脉冲幅度和平均LH水平均无差异。
结果不支持GnRH脉冲发生器减慢或其他改变是老年排卵女性单向性FSH升高基础这一假说。其他可能性包括这些女性中E2分泌的动态变化或FSH调节肽（即抑制素）的变化。
