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The ratio of LH (luteinizing hormone) to FSH (follicle-stimulating hormone), when measured in international units, is elevated in women with PCOS. Common cut-offs to designate abnormally high LH/FSH ratios are 2:1 [ 101 ] or 3:1 [ 94 ] as tested on day 3 of the menstrual cycle.
The anterior portion of the pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and the gonads produce estrogen and testosterone. In oviparous organisms (e.g. fish, reptiles, amphibians, birds), the HPG axis is commonly referred to as the hypothalamus-pituitary-gonadal-liver axis (HPGL-axis) in females.
Not all women with PCOS have difficulty becoming pregnant. For those who do, anovulation is a common cause. The mechanism of this anovulation is uncertain, but there is evidence of arrested antral follicle development, which, in turn, may be caused by abnormal interaction of insulin and luteinizing hormone (LH) on granulosa cells.
Follicle-stimulating hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone. [1] FSH is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland [2] and regulates the development, growth, pubertal maturation, and reproductive processes of the body.
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]
The biologic half-life of LH is 20 minutes, shorter than that of FSH (3–4 hours) and hCG (24 hours). [ citation needed ] The biological half-life of LH is 23 hours subcutaneous [ 7 ] or terminal half life of 10-12 hours.
While earlier menotropin medications contained FSH and LH at a 1:1 ratio, the recognition that it is FSH that is critical for follicle stimulation has led to development of newer preparations that contain a much higher FSH/LH ratio, Fertinex being an example. [4]
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