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Types of ovarian activity in women and their significance: the continuum (a reinterpretation of early findings).

Brown JB - Hum. Reprod. Update (2010)

Bottom Line: Unpredictable movement from fertile to infertile types and back can occur at any time during reproductive life.Stress is a major causative factor.The findings explain the erratic fertility of women and why ovulation is not always associated with fertility.

View Article: PubMed Central - PubMed

Affiliation: University of Melbourne, Melbourne, Victoria 3010, Australia.

ABSTRACT

Background: There are many types of ovarian activity that occur in women. This review provides information on the relationship between the hormone values and the degree of biological response to the hormones including the frequency and degree of uterine bleeding. The continuous process is termed the 'Continuum' and is thus similar to other processes in the body.

Methods: This review draws on information already published from monitoring ovarian activity by urinary oestrogen and pregnanediol measurements using timed 24-h specimens of urine. Much of the rationalization was derived from 5 to 6 year studies of girls progressing from childhood to adulthood, women progressing through menopause, and the return of fertility post-partum. During these times, all the reported types of ovarian activity were encountered.

Results: All cycle types can be understood in terms of steps in the normal maturation of fertility at the beginning of reproductive life, its return post-partum and its demise at menopause. Each step merges into the next and therefore the sequence is termed the 'Continuum'. Unpredictable movement from fertile to infertile types and back can occur at any time during reproductive life. Stress is a major causative factor. Hormonal definitions for each step, the relevance of the various cycle types in determining fertility and in the initiation of uterine bleeding and the roles of the pituitary hormones in causing them, are presented.

Conclusions: The findings explain the erratic fertility of women and why ovulation is not always associated with fertility. They provide an understanding of the various types of ovarian activity and their relation to pituitary function, fertility and uterine bleeding.

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Related in: MedlinePlus

Daily TE and pregnanediol values in 61 ovulatory menstrual cycles from 26 parous and 14 iparous women aged 20–40 years. All values are plotted and the 10th, 50th and 90th percentile lines are shown. The ovulatory oestrogen peak was identified in every cycle and the days are numbered from this day (=day 0). Reprinted with permission from Brown et al. (1981). Copyright Advocate Press and Ovulation Method Research and Reference Centre of Australia, Melbourne.
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DMQ040F1: Daily TE and pregnanediol values in 61 ovulatory menstrual cycles from 26 parous and 14 iparous women aged 20–40 years. All values are plotted and the 10th, 50th and 90th percentile lines are shown. The ovulatory oestrogen peak was identified in every cycle and the days are numbered from this day (=day 0). Reprinted with permission from Brown et al. (1981). Copyright Advocate Press and Ovulation Method Research and Reference Centre of Australia, Melbourne.

Mentions: Starting at puberty, the adrenal glands produce steroids that are metabolized to the same urinary products as ovarian oestradiol or oestrone and progesterone, and this persists for the remainder of life. These are seen as low, approximately constant TE values, usually <10 µg/24 h and pregnanediol values <0.5 mg/24 h. These values are influenced by a number of factors including the weight of the subject. Growth and regression of a dominant follicle are identified as unambiguous fluctuations of oestrogen values superimposed above these figures with rises of ∼1.4 times per day over 3–5 days to a peak and falls of approximately 0.7 times per day over 2–3 days after the peak (Fig. 1). After commencing its rapid growth phase, each follicle has a limited life-span, whether its end is caused by ovulation or death by atresia. To determine which has occurred, it is necessary to test for progesterone output.Figure 1


Types of ovarian activity in women and their significance: the continuum (a reinterpretation of early findings).

Brown JB - Hum. Reprod. Update (2010)

Daily TE and pregnanediol values in 61 ovulatory menstrual cycles from 26 parous and 14 iparous women aged 20–40 years. All values are plotted and the 10th, 50th and 90th percentile lines are shown. The ovulatory oestrogen peak was identified in every cycle and the days are numbered from this day (=day 0). Reprinted with permission from Brown et al. (1981). Copyright Advocate Press and Ovulation Method Research and Reference Centre of Australia, Melbourne.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3039221&req=5

DMQ040F1: Daily TE and pregnanediol values in 61 ovulatory menstrual cycles from 26 parous and 14 iparous women aged 20–40 years. All values are plotted and the 10th, 50th and 90th percentile lines are shown. The ovulatory oestrogen peak was identified in every cycle and the days are numbered from this day (=day 0). Reprinted with permission from Brown et al. (1981). Copyright Advocate Press and Ovulation Method Research and Reference Centre of Australia, Melbourne.
Mentions: Starting at puberty, the adrenal glands produce steroids that are metabolized to the same urinary products as ovarian oestradiol or oestrone and progesterone, and this persists for the remainder of life. These are seen as low, approximately constant TE values, usually <10 µg/24 h and pregnanediol values <0.5 mg/24 h. These values are influenced by a number of factors including the weight of the subject. Growth and regression of a dominant follicle are identified as unambiguous fluctuations of oestrogen values superimposed above these figures with rises of ∼1.4 times per day over 3–5 days to a peak and falls of approximately 0.7 times per day over 2–3 days after the peak (Fig. 1). After commencing its rapid growth phase, each follicle has a limited life-span, whether its end is caused by ovulation or death by atresia. To determine which has occurred, it is necessary to test for progesterone output.Figure 1

Bottom Line: Unpredictable movement from fertile to infertile types and back can occur at any time during reproductive life.Stress is a major causative factor.The findings explain the erratic fertility of women and why ovulation is not always associated with fertility.

View Article: PubMed Central - PubMed

Affiliation: University of Melbourne, Melbourne, Victoria 3010, Australia.

ABSTRACT

Background: There are many types of ovarian activity that occur in women. This review provides information on the relationship between the hormone values and the degree of biological response to the hormones including the frequency and degree of uterine bleeding. The continuous process is termed the 'Continuum' and is thus similar to other processes in the body.

Methods: This review draws on information already published from monitoring ovarian activity by urinary oestrogen and pregnanediol measurements using timed 24-h specimens of urine. Much of the rationalization was derived from 5 to 6 year studies of girls progressing from childhood to adulthood, women progressing through menopause, and the return of fertility post-partum. During these times, all the reported types of ovarian activity were encountered.

Results: All cycle types can be understood in terms of steps in the normal maturation of fertility at the beginning of reproductive life, its return post-partum and its demise at menopause. Each step merges into the next and therefore the sequence is termed the 'Continuum'. Unpredictable movement from fertile to infertile types and back can occur at any time during reproductive life. Stress is a major causative factor. Hormonal definitions for each step, the relevance of the various cycle types in determining fertility and in the initiation of uterine bleeding and the roles of the pituitary hormones in causing them, are presented.

Conclusions: The findings explain the erratic fertility of women and why ovulation is not always associated with fertility. They provide an understanding of the various types of ovarian activity and their relation to pituitary function, fertility and uterine bleeding.

Show MeSH
Related in: MedlinePlus