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PubMed1997

Reduced in vitro fertilization of human oocytes correlates with raised circulating FSH levels during ovarian stimulation in normogonadotropic women downregulated with GnRH-analogues.

PURPOSE: The possible effects of circulating FSH levels as used during IVF treatment on oocyte maturation and subsequent preembryo development were evaluated. METHODS: Serum levels of FSH and LH on days 1 and 8 of ovarian stimulation and on the day of oocyte retrieval (OR) were correlated with subsequent preembryo development in vitro. After pituitary downregulation, 244 normogonadotropic women followed a fixed protocol for the first 7 days of stimulation. RESULTS: The average FSH concentration on day 8 of stimulation was 11.5 IU/L and exceeded the expected midcycle surge of FSH by more than 25%. In contrast, levels of LH were below an average of 2 IU/L throughout the stimulation period. The concentration of FSH on day 8 and on the day of OR showed a significant inverse correlation with cleavage rate, whereas levels of LH, age, and body mass index showed no such correlation. CONCLUSIONS: Supraphysiologic levels of FSH seems to affect oocyte maturation negatively. Premature resumption of meiosis, leading to retrieval of postmature oocytes with a reduced developmental potential, is suggested as the underlying mechanism.

Adult↗
PubMed2004

FSH time-concentration profiles before and after administration of 0.25 mg cetrorelix in the gnRH-antagonist multiple-dose protocol for ovarian hyperstimulation.

PURPOSE: To determine FSH concentration behavior before and after cetrorelix 0.25 mg administration in the GnRH-antagonist multiple-dose protocol on day 6 of ovarian stimulation with 150-300 IU daily recombinant FSH. METHODS: Blood samples for FSH measurements were drawn from seven women every 15 min from 8 h prior to the first cetrorelix administration in the GnRH-antagonist multiple-dose protocol until 15-32 h thereafter. RESULTS: No significant change of FSH concentration was observed. CONCLUSIONS: This observation indicates that no rationale exists of increasing the daily FSH dosage concomitantly to the GnRH-antagonist administration to compensate for a drop of endogenous FSH.

Biomarkers↗
PubMed1997

Ontogeny of growth hormone and LH beta-, FSH beta- and alpha-subunit mRNA levels in the porcine fetal and neonatal anterior pituitary.

The mechanism underlying the ontogenetic increase in plasma growth hormone (GH), luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentration during fetal life in mammalian species and the prenatal sex difference in these hormones in some species is not fully understood. To this end anterior pituitaries were collected from German Landrace fetuses and piglets at day (d) 50, 65, 80, 95, 110 pc and d 6 pp and pituitary GH, LH beta, FSH beta and alpha-subunit mRNA levels were determined by measuring Northern blot hybridization signals. GH mRNA was detected in both sexes as early as d 50 pc. The mRNA level markedly increased with age in both sexes (males > females, P < or = 0.05) reaching its maximum at d 95/110 pc. LH beta mRNA signals were first detected at d 50 pc in females and at d 65 pc in males increasing thereafter to a maximum at d 6 pp in both sexes (P < or = 0.05). In males the augmentation in LH beta mRNA was delayed compared to females (P < or = 0.01). Before d 80 pc no FSH beta mRNA hybridization signals were apparent. Thereafter the mRNA level continuously increased with age (P < or = 0.01) in both sexes reaching its maximum at d 6 pp. The FSH beta mRNA level in females was always higher than in males (P < or = 0.01). As early as d 50 pc the alpha-subunit mRNA level was high in both sexes and further increased without sex difference to d 6 pp (P < or = 0.05). In conclusion, the mRNA levels of GH, LH beta and FSH beta are age and sex dependent during fetal development. We suggest that the fetal increase in plasma GH concentration can be accounted for by changes in GH mRNA levels, while the dramatic perinatal decrease in plasma GH concentration seems to be primarily controlled at the posttranslational and/or secretion level. The fetal sex difference and the increase in plasma LH and FSH concentrations seems to be primarily dependent on the cellular concentration of the gonadotropin beta-subunit mRNAs and/or number of gonadotrophs.

Age Factors↗
PubMed1982

FSH and LH variations in beef cows during the postpartum period.

To study the plasma gonadotrophin profiles of 9 cows after parturition, blood samples were obtained every 20 min for 12 hrs on three occasions between 5 and 50 days postpartum and analysed by RIA techniques. The time of the first ovulation, as judged by plasma progesterone levels, varied from 30 to more than 60 days postpartum. Variations in mean levels of FSH and LH were not significantly correlated with the postpartum interval. However, the mean levels of plasma FSH and number of LH pulses were lower in females which had not ovulated than in those which had. The cows could be classified into four groups: group 1 with less than 4 LH pulses in 12 hrs and a mean plasma FSH level less than 138 ng/ml; group 2 with more than 4 LH pulses in 12 hrs and varying plasma FSH levels; group 3 with less than 4 LH pulses in 12 hrs and a mean plasma FSH level greater than 138 ng/ml; group 4 which had ovulated. This classification indicated that the LH and FSH levels progressed significantly (2.46 to 3.56 ng/ml, P less than 0.05; 120 to 159 ng/ml, P less than 0.01, respectively) from groups 1 to 3, and that they decreased in the females which had ovulated (group 4). Since the time of the first ovulation after parturition varied, it was not possible to demonstrate any relationship between that interval and the mean plasma gonadotrophin profiles. However, when ovulation was considered as time zero there was a clear increase in plasma gonadotrophin before ovulation.

Animals↗
PubMedDate not supplied

Ram lambs need FSH for normal testicular growth, Sertoli cell numbers and onset of spermatogenesis.

The effect of FSH on the development of the testis in the ram lamb was examined in two experiments where lambs were passively immunized against ovine beta-FSH from birth until 100 or 160 d. In both experiments, immunization resulted in a slower testicular growth relative to that of controls. This effect became apparent at around the start of the period of rapid testicular growth (60-70 d of age) and resulted in testicular weights at the end of treatment ranging from 37 to 51% of those of control groups. Within the testis, this was reflected in shorter seminiferous tubules (48-64% of controls) and in lower numbers of Sertoli cells per testis (57-82%). In the rams immunized until 160 d of age, spermatogenesis had begun and immunization against FSH provoked a lower production of germinal cells which was not solely due to the lower number of Sertoli cells but also due to fewer germinal cells being supported by each Sertoli cell. However, the numbers of A0 spermatogonia per testis and the daily production of the A1 spermatogonia were unaffected by immunization, but the production of the B2 spermatogonia and, as a consequence, of leptotene and pachytene spermatocytes and of round spermatids were all markedly lower (43-47% of controls). These effects were not due to any decreases in the secretion of LH or testosterone as seen in the blood levels of these two hormones. These results show that, in the ram lamb, FSH is essential for normal testicular development and for the establishment of a normal population of Sertoli cells. They also confirm that, once spermatogenesis is established, FSH is necessary for a normal production of germinal cells, with one or more of the divisions between the A1 and B2 spermatogonia being sensitive to suppression of FSH.

Animals↗
PubMed1992

Biochemical factors involved in the FSH action on amino acid transport in immature rat testes.

Testes of 15-day-old rats preincubated and incubated during different times with various doses of FSH (0.2; 2.0 and 20.0 mU/ml) in Krebs-Ringer bicarbonate (KRb) buffer increase the uptake of [14C] methylaminoisobutyric acid and [14C] aminoisobutyric acid. The basal and FSH stimulated amino acid transport occurs at absolute lower levels when the protein or glycoprotein synthesis is inhibited by cycloheximide (350 mumol/l) or tunicamycin (12 mumol/l) or when the microtubules are depolymerized with colchicine (1.2 mumol/l). However, the proportional increase of amino acid transport produced by FSH was maintained. The blockage of the voltage-dependent Ca++ channels with verapamil or the competitive inhibition of the bivalent ion channels by Co++ or Ni++ nullified the stimulatory action of FSH on the amino acid transport. Also quinine, that blocks the ATP dependent K+ channels, abolished the FSH action. It was concluded that in immature rat testes FSH stimulates amino acid transport through a mechanism involving voltage-dependent Ca++ channels and ATP-sensitive K+ channel.

Amino Acids↗
PubMed1989

Effect of calcitonin and 1,25(OH)2-vitamin D3 on the FSH, LH and testosterone secretion at rest and LHRH stimulated secretion.

The calcium signal plays an important role in the control of the secretory process of some adenohypophyseal hormones which responds to the administration of calciotropic substances by a marked change. In the submitted work the effect of calcitonin and 1,25(OH)2-vitamin D3 (1,25(OH)2D3) on FSH, LH and testosterone secretion was investigated. A single dose of 50 U synthetic salmon calcitonin did not influence the FSH, LH and testosterone secretion at rest nor stimulated secretion. 1,25(OH)2D3 administered for four days in amounts of 3 micrograms/day did not affect the LH and testosterone secretion but increased slightly the secretory response of FSH to LHRH, significantly during the 80th minute following administration of the secretagogue (P less than 0.01). The indication of bi-phasic FSH secretion was eliminated by 1,25(OH)2D3. The significant decline of PTH levels following administration of 1,25(OH)2D3 is evidence of a biologically effective level of 1,25(OH)2D3 attained by the administered dose of hormone. As compared with the marked effect of calcitonin and 1,25(OH)2D3 on thyrotropic hormone secretion, it may be concluded that the gonadotropic system is considerably less sensitive to a change of calcium homeostasis induced by calcitonin or 1,25(OH)2D3. Nevertheless a slight increase of the FSH secretion and a change of the dynamics of its secretion suggest a modulating role of 1,25(OH)2D3 in the control of FSH secretion.

Adult↗
PubMed1982

Dissociation of LH and FSH Responses to LHRH during estrogen therapy of patients with ovarian failure.

This study examines the effect of oral estrogen treatment on gonadotropin secretion in three young women with gonadal failure. Each subject was treated with 0.1 mg BID of ethinyl estradiol for four weeks, and the LH and FSH responses to 200 microgram of intravenously administered LHRH were measured basally and weekly during therapy. Significant reduction of basal levels of FSH occurred within one week of treatment, with obliteration of LHRH-mediated FSH responsiveness within two weeks. By contrast, basal levels of LH were significantly reduced by the end of the second week of treatment, and LHRH-mediated LH levels were sustained for three weeks. In one subject an LHRH test was performed every other day for two weeks after cessation of therapy. Return of FSH responsiveness was delayed one week beyond that of LH, which occurred within three days of discontinuation of estrogen. These results indicate that during the early phase of oral estrogen replacement therapy, FSH secretion may be selectively blunted; after discontinuation of treatment, recovery of FSH secretion lags behind recovery of LH.

Adult↗
PubMed1991

Effects of growth factors and hormones on basal and FSH-stimulated inhibin production by porcine granulosa cells in vitro.

The effect of several growth factors, protein and steroid hormones on follicle stimulating hormone (FSH)-stimulated and basal inhibin secretion by mature porcine granulosa cells (g-cells) in culture was examined in order to elucidate the putative role of growth factors and hormones in the regulation of inhibin secretion by porcine g-cells in vitro. Cells were incubated with the respective hormones over a timespan of 0-144 h and immunoreactive inhibin was measured with a radioimmunoassay against porcine inhibin. Epidermal growth factor (EGF) and human transforming growth factor type beta (TGF-beta) decreased basal and gonadotrophin-stimulated inhibin and progesterone in a dose-dependent manner. In the absence of insulin, insulin-like growth factor type I (IGF-I) caused a 4-fold enhancement of basal inhibin secretion, but inhibin secretion was elevated only to 20% above control in the presence of 500 nM insulin. Porcine platelet-derived growth factor (PDGF) had no significant effect on basal or FSH-induced inhibin secretion by g-cells. In addition, neither gonadotrophin-releasing hormone (GnRH) nor prolactin (PRL), arginine vasopressin (AVP) and oxytocin affected basal or FSH-stimulated inhibin release by porcine g-cells. Oestradiol caused a slight but significant (P less than 0.01) rise of basal inhibin production (158% of control) in the last 2 days of culture (96-144 h) and the effect of androstenedione on basal (158% of control) and FSH-stimulated (140% of control) inhibin release (P less than 0.01) was also only visible on Days 4-6 of culture. In contrast to androstenedione and oestradiol, progesterone did not show any effect during 6 days of culture in a dose range of 10(-5) to 10(-9) M. Like steroids, prostaglandin E2 (PGE2) had a stimulatory effect on basal inhibin production (250% of control) by porcine g-cells, visible on Days 3-6 of culture, but an inhibitory effect on FSH-stimulated release (less than 40% of control). Over all the experiments with different hormones and growth factors, tested in varying doses and over a time span of 0-144 h, there was a strong correlation between progesterone and inhibin secretion by g-cells (0-48 h = 0.78; 48-96 h = 0.92; 96-144 h = 0.92). These results suggest that EGF, TGF-beta, IGF-I, oestradiol and androstendione as well as PGE2 have para- and/or autocrine modulatory effects on basal and FSH-stimulated inhibin secretion by mature porcine g-cells in vitro and further demonstrate that the secretion of the proteohormone inhibin and the steroid progesterone are closely related.

Androstenedione↗
PubMed1992

Effects of the ovary, sucking stimulus and season on the pattern of LH and FSH release in the female tammar, Macropus eugenii.

The sequential effects of removal of the corpus luteum, removal of the non-luteal ovary and sucking stimulus and the effects of season of the year on the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH) have been determined in the tammar wallaby, Macropus eugenii. Plasma concentrations of LH and FSH were measured at 15 min intervals for 6 h in eight animals at four successive times in the breeding season (lactational quiescence); (A) while they were intact and lactating, (B) 10 days after removal of the ovary bearing the quiescent corpus luteum, (C) 21 days after bilateral ovariectomy and (D) 21 days after removal of the sucking stimulus, and (E) in the following non-breeding season (seasonal quiescence). Single blood samples were taken twice weekly during lactational quiescence. In the presence of ovarian tissue, basal concentrations of LH were low (0.94 ng mL-1) with pulses of low magnitude (1.3 ng mL-1) and low frequency (1.4 pulses per 6 h). There was no response to luteectomy but all three parameters increased after bilateral ovariectomy. Removal of the sucking stimulus affected the LH pulse frequency but seasonal differences were not evident. The pattern of release of FSH was not pulsatile. There was no response to luteectomy in basal concentrations of FSH but these rose significantly after bilateral ovariectomy (P less than 0.001) in lactational quiescence. There was no effect of removing the sucking stimulus but in seasonal quiescence concentrations were higher. The results indicate that non-luteal ovarian tissue is essential for the negative-feedback effects on LH and FSH secretion, that the pattern of release of LH, but not FSH, is pulsatile, and that there is no marked seasonal change in hypothalamo-hypophysial activity.

Animals↗
PubMed1998

Effect of constant and of changing photoperiod on plasma LH and FSH concentrations and age at first egg in layer strains of domestic pullets.

1. ISA Brown pullets were transferred from 8 to 14 h or from 14 to 8 h photoperiods at 35 or 56 d of age. Controls were maintained on constant 8 or 14 h photoperiods from day 1. 2. Blood samples were obtained immediately before each daylength change and subsequently at 7 d intervals until 1st egg in the treated groups and at 70 d of age and then at 14 d intervals until 1st egg in the constant photoperiod controls. Plasma luteinising hormone (LH) and follicle stimulating hormone (FSH) concentrations were determined using homologous radioimmunoassays. 3. Prior to 16 weeks, LH was consistently higher in birds on constant 14 h photoperiods than in those on constant 8 h, but was down-regulated as birds approached maturity so that LH concentrations in the 2 groups were similar during the final 10 d before the first egg was laid. FISH concentrations rose steadily with age but with a tendency for concentrations to be higher in the 8 h than in the 14 h treatment. Birds on constant 8 h daylengths matured 18.3 d later than those on constant 14 h photoperiods. 4. A 6 h increment in photoperiod given at 35 d or 56 d, resulted in an increase in LH within 7 d in both cases. FSH concentration did not respond to an increase in photoperiod at 35 d but rose following the same increase at 56 d. This was associated with a 3-week advance in sexual maturity, whilst age at 1st egg in birds photostimulated at 35 d was similar to the age with a constant 14 h photoperiod. 5. LH concentration fell when photoperiod was reduced from 14 to 8 h at either 35 or 56 d and remained below the constant 8 h controls for many weeks before rising to a concentration not significantly different from other groups in the final 10 d before 1st egg. FSH concentrations in birds exposed to a decreased daylength at 35 d, although more oscillatory, were similar to the constant 8 h photoperiod controls. In birds exposed to the same decrease at 56 d, FSH concentration initially tumbled but was similar in the 2 groups during the latter stages of rearing; neither differed significantly from the constant daylength controls during the 60 d before 1st egg. Sexual maturity in both groups given a reduction in photoperiod was delayed by about 2 weeks compared with constant 8 h controls. 6. Change in FSH concentration following an increase in daylength was a better predictor of age at 1st egg than change in LH. However, FSH concentrations after 14 weeks of age were rather similar in short day and long day controls and in the 2 groups given reductions in photoperiod at 35 d and 56 d, despite differences of nearly 5 weeks in mean age at 1st egg amongst these 4 treatments.

Animals↗
PubMed1984

FSH and LH response to testosterone and gonadotropin-releasing hormone in aging male rats.

Gonadotropins were measured in young (3 months) and old (24 months) male Sprague-Dawley rats. Basal levels of LH were lower in old animals, whereas the basal levels of FSH were unchanged. The levels of gonadotropins increased significantly following castration in both age groups, However the old animals secreted less LH than the young. When 50 mg/100 g BW of testosterone propionate (TP) was given, the postcastration levels of FSH and LH were suppressed only in the old rats. When higher doses of TP were given, the levels of FSH and LH were reduced in both groups. However these levels remained suppressed longer in the old rat than in the young. The levels of FSH and LH were elevated after an iv injection of 10 or 100 ng gonadotropin releasing hormone (GnRH/100 g BW. FSH levels were similar in both groups of animals. LH values were higher in the young rats only after the injection of 100 ng GnRH/100 g BW. These data suggest that age differentially influences the control mechanisms for FSH and LH secretion.

Aging↗
PubMed1996

Controlled ovarian stimulation using highly purified FSH results in a lower serum oestradiol profile in the follicular phase as compared with HMG.

We have examined the efficacy of highly purified follicle stimulating hormone (FSH-HP) for controlled ovarian stimulation in our in-vitro fertilization (IVF) programme, and compared the results obtained with this preparation with those using human menopausal gonadotrophin (HMG) in 15 patients who had received treatment with both FSH-HP and HMG in consecutive cycles (n = 39). No differences were found in the duration of stimulation, which was 13.9 days (HMG) as compared with 14.3 days (FSH-HP). However, in the FSH-HP-treated cycles we found a striking difference in the rise of serum oestradiol, which was significantly lower than in HMG-treated cycles (2953 +/- 938 pmol/l as compared with 6349 +/- 3683 pmol/l on the day before ovum retrieval). Number and size of follicles were similar in the two groups, as were oocyte characteristics. Increase in endometrial thickness at two days prior to ovum retrieval was slightly higher after HMG. The results indicate that in combination with a long gonadotrophin-releasing hormone agonist (GnRHa) protocol, pure FSH is sufficient for adequate follicle recruitment and growth. However, since FSH-HP resulted in markedly reduced concentrations of serum oestradiol as compared to HMG cycles, IVF programmes using repeated oestradiol measurements to decide the day of ovum retrieval must take this into consideration in order not to prolong the stimulation unnecessarily.

Adult↗
PubMed1998

Synchronization of endogenous and exogenous FSH stimuli in controlled ovarian hyperstimulation (COH).

We have previously observed that exogenous oestradiol can delay the intercycle increase in plasma follicle stimulating hormone (FSH). The increase in plasma FSH that follows discontinuation of exogenous oestradiol peaks after 3 days. We have now studied the possibility of using exogenous oestradiol to synchronize the increase in endogenous FSH with the onset of human menopausal gonadotrophin (HMG) treatment in controlled ovarian hyperstimulation (COH). A total of 30 women aged 35.1+/-6.3 years (mean+/-SD) undergoing ovarian stimulation received 2 mg of oestradiol valerate twice daily starting on day 25 of the previous menstrual cycle until the first Tuesday following menses. Ovarian stimulation was initiated 3 days later. On the last day of oestradiol treatment, plasma oestradiol, FSH and luteinizing hormone (LH) (mean+/-SEM) were 566+/-53 (pmol/l), 3.8+/-0.4 (IU/l) and 5.5+/-0.8 (IU/l) respectively. After 3 days, the FSH and LH (mean+/-SEM) had increased to 6.7+/-0.7 and 6.9+/-0.7 (IU/l) respectively while oestradiol decreased to 251+/-29 (pmol/l). The mean number (+/-SEM) of HMG ampoules used was 25.1+/-2.7 and treatment lasted 11.3+/-0.9 days. Five women became pregnant for a pregnancy rate (ongoing) of 19 (15)%. If all women aged >40 years (six women who did not become pregnant) were excluded from analysis the pregnancy rate (ongoing) was 24 (19%). These results indicate that exogenous oestradiol can safely be used for the synchronization of endogenous and exogenous FSH stimuli in COH. This approach provides the practical advantage of permitting an advanced timing of the onset of COH treatments when gonadotrophin-releasing hormone (GnRH) agonists are not used, which improves treatment convenience for patients and team members alike. Further development of this model may enable control of the onset of natural cycles which may find practical applications for timing assisted reproductive techniques (intrauterine insemination or in-vitro fertilization) in the natural cycle.

Adult↗
PubMed2000

Reactivity of different LH and FSH standards and preparations in the world health organization matched reagents for enzyme-linked immunoassays of gonadotrophins.

The immunoreactivity of various LH and FSH calibration standards and recombinant preparations in the enzyme-linked immunoassay (EIA) systems for gonadotrophins developed for the Special Programme of Research in Human Reproduction of the World Health Organization (WHO) were compared. The preparations tested included three LH and two FSH pituitary standards (calibrated against LH 80/552 and 68/40 and FSH 78/549 respectively) provided with the EIA or radioimmunoassay WHO matched reagent kits, the pituitary preparation LER-907, and recombinant human LH (rhLH) and FSH (rhFSH). Simultaneous curve fitting of the EIA dose-response curves revealed no significant differences among the slopes generated by the WHO LH standards and LER-907; in contrast, no parallelism was found between the curves of rhLH and the pituitary-derived LH standards. No significant differences were found among the slopes of the curves elicited by the pituitary and recombinant FSH preparations. Each LH preparation exhibited a high degree of charge heterogeneity. Considerable variations in charge isoform distribution among the WHO LH standards, rhLH and LER-907 were also evident. In contrast, the FSH preparations were less heterogeneous and exhibited minor differences in charge distribution. Despite the existing differences in charge isoform distribution, all the pituitary-derived preparations as well as rhFSH seem appropriate for using as calibration standards in this particular EIA system.

Animals↗
PubMed2000

Day 3 serum inhibin B and FSH and age as predictors of assisted reproduction treatment outcome.

Recent reports investigating the value of basal inhibin B determination as a predictor of ovarian reserve and assisted reproduction treatment have led to discordant results. This study was undertaken to further assess the relative power of day 3 inhibin B and follicle stimulating hormone (FSH) (defined before treatment) and the woman's age both as single and combined predictors of ovarian response and pregnancy in an in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) programme. A total of 120 women undergoing their first cycle of IVF or ICSI was included. Forty consecutive cycles cancelled because of poor follicular response were initially selected. As a control group, the nearest completed IVF/ICSI cycles before and after each cancelled cycle (i.e. the closest cycles in temporal relationship to the index cycle) were used. Mean age and basal FSH concentrations were significantly higher in the cancelled than in the control group (P: < 0.01 and P: < 0.001 respectively), whereas basal inhibin B was significantly higher in the latter (P: < 0.05). The association of basal FSH (with an accuracy or predictive value of ovarian response of 79%) with cancellation rate was significant, independent of, and stronger than the effects of age and inhibin B (P: < 0.05). Any two or all three of these variables studied did not improve the predictive value of FSH alone. Woman's age was the only variable independently associated with pregnancy rate. It is concluded that the stronger predictors of success in patients undergoing their first IVF/ICSI treatment cycle are age and basal FSH rather than inhibin B. Basal FSH concentration was a better predictor of cancellation rate than age, but age was a stronger predictor of pregnancy rate.

Adult↗
PubMed2001

Are elevated FSH concentrations in the pre-conceptional period a risk factor for Down's syndrome pregnancies?

Recent publications have reported a relation between a decreased ovarian reserve and Down's syndrome pregnancies. Using the data of a case-control study into risk factors for a Down's syndrome pregnancy, we estimated the usefulness of pre-conceptional basal follicle stimulating hormone (FSH) screening (detection rate, false positive rate, positive and negative likelihood ratio, as well as the loss rate of unaffected pregnancies) to identify Down's syndrome pregnancies. The optimal detection rate of pre-conceptional basal FSH screening for Down's syndrome pregnancies was 14%, corresponding to a false positive rate of 5% and a positive likelihood ratio of 2.8. Incorporation of basal FSH screening into the regimen of first trimester serum screening followed by nuchal translucency measurement would increase the detection rate from 85 to 87%. However, basal FSH screening alone or in combination with other screening methods would cause an unacceptably high loss rate of unaffected pregnancies compared with current screening protocols, indicating that routine pre-conception basal FSH screening would not be useful to identify women at risk for a Down's syndrome pregnancy. However, when elevated basal FSH concentrations are diagnosed during subfertility evaluation, an elevated risk for a Down's syndrome pregnancy could be discussed with women who become pregnant.

Down Syndrome↗
PubMed2003

Pseudo-isolated FSH deficiency caused by an inhibin B-secreting granulosa cell tumour: case report.

Isolated FSH deficiency due to a mutation in the FSHbeta subunit is characterized by an extremely low serum FSH concentration. We report a patient who presented with an FSH of 0.8 mIU/ml and infertility associated with anovulation. Endocrinological assessment and immunohistochemistry revealed that a granulosa cell tumour was secreting inhibin B and suppressing FSH; however, LH and estradiol were within their normal ranges. Upon removal of the tumour, inhibin B decreased and FSH levels rose to normal values. The patient subsequently conceived and delivered successfully. Based on this case and on those previously described in the literature, we suggest that inhibin B levels should be evaluated in anovulatory patients having a clinical presentation consistent with functional hypothalamic amenorrhoea and very low to normal values of FSH.

Adult↗