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Estrogen, progesterone, and human chorionic gonadotropin (hCG) levels throughout pregnancy. Estrogen, progesterone, and 17α-hydroxyprogesterone (17α-OHP) levels during pregnancy in women. [ 1 ] The dashed vertical lines separate the trimesters .
The initial endocrine evaluation includes testing for levels of TSH and free T4, prolactin, LH, FSH, estradiol (E2), and anti-Müllerian hormone (AMH). [9] FHA patients may display a combination of the following: FSH concentrations that are normal but lower than LH levels, low or low normal LH, E2 <50 pg/mL, and progesterone <1 ng/mL. [6]
A pregnancy test is a common first step for diagnosis. [50] Similar to primary amenorrhea, evaluation of secondary amenorrhea also begins with a pregnancy test, prolactin, FSH, LH, and TSH levels. [13] A pelvic ultrasound is also obtained. [13] Abnormal TSH should prompt a thyroid workup with a full thyroid function test panel. [13]
FSH levels in this time is often called basal FSH levels, to distinguish from the increased levels when approaching ovulation. [17] FSH is measured in international units (IU). For Human Urinary FSH, one IU is defined as the amount of FSH that has an activity corresponding to 0.11388 mg of pure Human Urinary FSH. [18]
Hypergonadotropic hypogonadism (HH), also known as primary or peripheral/gonadal hypogonadism or primary gonadal failure, is a condition which is characterized by hypogonadism which is due to an impaired response of the gonads to the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and in turn a lack of sex steroid production. [1]
During reproductive years, typical levels are between 1 and 20 IU/L. Physiologic high LH levels are seen during the LH surge (v.s.) and typically last 48 hours. In males over 18 years of age, reference ranges have been estimated to be 1.8–8.6 IU/L. [ 28 ]
In the female, the goal for gonadotropin therapy is to obtain ovulation. This is obtained with FSH treatment followed by hCG or LH to trigger ovulation. FSH will stimulate granulosa cells for follicular maturation while LH will act on luteal cells to produce steroids aiding follicular maturation and preparing the endometrium for pregnancy.
Gonadotropins are glycoprotein hormones secreted by gonadotropic cells of the anterior pituitary of vertebrates. [1] [2] [3] This family includes the mammalian hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH), the placental/chorionic gonadotropins, human chorionic gonadotropin (hCG) and equine chorionic gonadotropin (eCG), [3] as well as at least two forms of fish ...
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