LH peak後24h排卵

P4 在LH peak前開始上升
LH peak後24h排卵
E2 peak 在LH peak之前

高齡病患
FSH上升,
E2略升,
AMH下降, IGF下降, inhibin下降

http://humupd.oxfordjournals.org/content/18/1/73.full#ref-22

Ovarian antral folliculogenesis during the human menstrual cycle: a review

1. Angela R. Baerwald1,*, 
2. Gregg P. Adams2 and 
3. Roger A. Pierson3

+Author Affiliations

1. ¹Department of Obstetrics, Gynecology and Reproductive Sciences, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8
2. ²Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada S7N 5B4
3. ³Department of Obstetrics, Gynecology and Reproductive Sciences, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8

1. ↵*Correspondence address. Tel: +1-306-966-8073; Fax: +1-306-966-8040; E-mail: angela.baerwald@usask.ca

• Received February 4, 2011.
• Revision received August 15, 2011.
• Accepted August 24, 2011.

 

Next Section

Abstract

BACKGROUND Ovarian follicles undergo dynamic morphologic and endocrinologic changes during the human menstrual cycle. The physiologic mechanisms underlying recruitment and selection of antral follicles in women are not fully elucidated.

METHODS A comprehensive review of >200 studies was conducted using PubMed. The objective was to compare and contrast different perspectives on human antral folliculogenesis.

RESULTS Antral folliculogenesis has been studied using histologic, endocrinologic and/or ultrasonographic techniques. Different theories of antral follicle recruitment include: (i) continuous recruitment throughout the menstrual cycle; (ii) recruitment of a ‘cohort’ of antral follicles once in the late-luteal phase or early-follicular phase of each cycle and (iii) recruitment of two or three ‘cohorts’ or ‘waves’  during each cycle. Generally, a single dominant follicle is selected in the mid-follicular phase of each cycle and this follicle ovulates at mid-cycle. However, a dominant follicle may also be selected during anovulatory waves that precede the ovulatory wave in some women.

CONCLUSIONS There is increasing evidence to indicate that multiple waves of antral follicles develop during the human menstrual cycle. Ovarian follicular waves in women are comparable with those documented in several animal species; however, species-specific differences exist. Enhancing our understanding of the endocrine and paracrine mechanisms underlying antral follicular wave dynamics has clinical implications for understanding age-related changes in reproductive function, optimizing hormonal contraceptive and ovarian stimulation regimens and identifying non-invasive markers of the physiologic status of follicles which are predictive of oocyte competence and assisted reproduction outcomes.