Hypothalamic-Pituitary-Ovarian Axis Disorders Impacting Female Fertility

Abstract

The hypothalamic-pituitary-ovarian (HPO) axis is a tightly regulated system controlling female reproduction. HPO axis dysfunction leading to ovulation disorders can be classified into three categories defined by the World Health Organization (WHO). Group I ovulation disorders involve hypothalamic failure characterized as hypogonadotropic hypogonadism. Group II disorders display a eugonadal state commonly associated with a wide range of endocrinopathies. Finally, group III constitutes hypergonadotropic hypogonadism secondary to depleted ovarian function. Optimal evaluation and management of these disorders is based on a careful analysis tailored to each patient. This article reviews ovulation disorders based on pathophysiologic mechanisms, evaluation principles, and currently available management options.

Recent trends in stem cell therapy for premature ovarian insufficiency and its therapeutic potential: a review

“…The gold-standard diagnostic is the change in the levels of the main ovarian hormones (low estradiol (E2), follicle-stimulating hormone (FSH) ≤40 mIU/ml) [1]. Generally, ovarian function is controlled by the hypothalamicpituitary-ovarian axis [12]. Gonadotropin-releasing hormone (GnRH) released from the hypothalamus prompts the anterior pituitary gland to secrete FSH and luteinizing hormone (LH), which act on the ovary.…”

Computer-Aided Ligand Discovery for Estrogen Receptor Alpha

“…Primarily, androgen synthesis from cholesterol occurs in the thecal cells of ovaries and aromatization of these androgens in granulosa cells leads to the production of estrogens but they can also be produced by other non-gonadal sites such as brain, adipose tissue, bones, liver, adrenal gland, skin and blood vessels [116,124]. Estrogen formation is tightly regulated by the hypothalamic pituitary ovarian axis [125,126]. Gonadotropin-releasing hormone stimulates the anterior pituitary gland to release two hormones: luteinizing hormone, which initiates the synthesis of testosterone, and follicle-stimulating hormone, which regulates the expression of aromatase cytochrome P450 [125].…”

Reproductive toxic agents in work environments and related cases in Korea

“…Hexane (n-hexane) was 3,315 (9.8%), 1,900 for 2-ethoxy-ethanol (5.62%), 1,833 for N, N-dimethylacetamide (5.42%), 1,806 for carbon monoxide (5.34%), and 1,633 for lead (4.83%). In particular, the proportion of workers exposed to lead or carbon monoxide, which belong to reproductive toxicity 1A, was 20.3% of 16,833 total women workers exposed to chemical reproductive toxicity factors [12].…”

“…There are six components for normal gestation and reproduction: (1) fertility, (2) conception, (3) implantation and preclinical gestation, (4) clinical pregnancy and fetal development, (5) birth, and (6) postnatal development. Fertility factors include the neuro-endocrine gonadal axis, oocyte development and ovulation, and anatomical integrity for passage of sperm and eggs [16]. Adverse effects on one or more of these three factors may act as a reproductive toxicity factor.…”