Hormonal profile after removal of the dominant follicle and corpus leteum in women.

Abstract

The mechanism of the selection and maturation of a dominant follicle in women was examined. Eight normally menstruating women undergoing myonectomy or tubal surgery volunteered for the present study. In 3 patients who were operated on Day 9-11, a visual dominant follicle was removed. The other 5 patients underwent the removal of a newly developing corpus luteum on Day 15-21. After taking 3 or 4 preoperative blood samples in the morning after their hospitalization, blood was obtained at 3 or 6 h intervals for the first 36-45 h and at 1-3 day intervals thereafter for 21-34 days. Serum FSH, LH [luteinizing hormone], estradiol and progesterone were measured by radioimmunoassay. Follicletomy was followed by a sudden drop in estradiol and a minor increase in progesterone. FSH increased for a few days and then declined. There was a drastic, but short-term increase in LH following folliclectomy which was performed before a preovulatory gonadotropin surge. A LH surge occurred 10.7 .+-. 1.2 days (mean .+-. SE) after follicular ablation followed by luteal phase. In contrast, there was no remarkable LH release in 4 out of 5 patients who underwent luteectomy. A slightly higher level of FSH was sustained for 2-7 postoperative days. Luteal phase rises in estradiol and progesterone terminated promptly following luteectomy. A LH surge was observed 14.2 .+-. 1.7 days after surgery followed by a luteal phase. After either type of operation, a sustained increase in FSH was followed by a gradual increase in estradiol which preceded a gonadotropin surge. These hormonal sequences resemble those seen in the normal follicular phase. Folliclectomy and luteectomy bring on some characteristic hormonal changes which may exert stimulatory or suppressive effects on the selection and maturation of a dominant follicle after the removal of a main ovarian cyclic structure culminating in ovulation at a certain interval.