Estrogen biosynthesis—regulation, action, remote effects, and value of monitoring in ovarian stimulation cycles

摘要: Objective To review current knowledge regarding estrogen biosynthesis, its regulation and action, specifically concerning local as opposed to remote effects of this hormone, examine the effectiveness prognostic value monitoring hormone concentrations endometrial response in cycles controlled ovarian hyperstimulation. Data Identification Selection Studies that relate enzymatic pathways, receptor physiology, clinical aspects were identified through literature Medline searches. Results Folliculogenesis is basic unit activity, which has a dual purpose: oocyte maturation steroid production. Steroidogenic granulosa theca cells cooperate under gonadotropin control produce estrogens by stimulating synthesis steroidogenic enzyme messenger RNAs. Steroid amplified further growth factors follicular cell multiplication. Estrogen directed FSH, only small amounts LH are needed amplify estrogenic potential. However, preovulatory follicles can proceed without LH, FSH only, even presence low peripheral levels. Oocyte fertilization may independently ambient levels, leading assumption exerts minimal autocrine-paracrine function. The notable effect production promote adequate receptive endometrium for embryo implantation. Clinical treatment be monitored more effectively evaluating end-organ rather than absolute serum E 2 or sonographic measurements. Conclusion Follicular regulated complex set signals synergize optimal steroidogenesis. Most importantly, truly an endocrine effect, it prepares Therefore, goal effective strategies should focus on direct assessment biologic activity optimizes receptivity anticipation subsequent