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KMID : 0358419960390010127
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Korean Journal of Obstetrics and Gynecology
1996 Volume.39 No. 1 p.127 ~ p.136
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Interrelationship betweenSerum LH, FSH, Estradiol, Progesterone, 17 a-hydroxyprogesterone Levels and Follicular Size in Normal Menstrual Cycle
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Abstract
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The accurate prediction and detection of ovulation is important in the success of artificial insemination with husband and donorsemen, ovulation induction, and in vitro fertilization and embryo transfer(IVF-ET) in controlled ovarian
hyperstimulation or
normal menstrual cycle. In 20 infertile patients, who had only tubal factor and wanted IVF-ET in natural menstrual cycle, serum LH, FSH, Estradiol(Ew), Progesterone(P4), 17a-hydroxyprogesterone(17-OHP) levels and follicular size were measured
from
July
to December, 1990. Their interrelationships in respect to LH surge(D 0), which has been considered as the best predictor of ovulation, are as follows.
Serum LH concentration increased gradually followed by rapid increment from D-1 to the peak of 134.8±15.99mIU/ml at D 0 and then decreased. Serum FSH concentration was reached the peak level of 31.50±3.68mIU/ml at D 0. Serum E2 level increased
from
46.44±9.10pg/ml(D-6) to the peak level of 261.8±33.94pg/ml(D-1), and remained plateau until began to decrease at D+1, P4 level revealed significant increment at D 0 as 0.447±0.104ngm/ml. Serum concentration of 17-OHP elevated gradually until
significant elevation to 1.613±0.224ngm/ml was detected at D 0. And ovarian follicle was grown by 1.6mm/day from 10.21±4.94mm(D-6) to 19.83±1.05mm(D 0).
There was a good statistical correlation between serum E2 level and mean follicular diameter through late follicular phase(r=0.94, p<0.001), between serum LH and P4 levels at D 0(r=0.66, p<0.01), and between LH and 17-OHP at D-1(r=0.73, p<0.01).
In
relation to the ratio of hormonal increment of D 0 from D-1, there were significant correlation between LH and P4, between LH and 17-OHP, and statistically significant correlation between LH and 17-OHP at D-1 from D-2.
So it may be useful to measure follicular size, check serum P4, 17-OHP concentration, and calculate the ratio of increment of P4 and 17-OHP at late follicular phase as complementary method to expect LH surge and further more to predict ovulation.
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KEYWORD
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