The onset of the initial rise in follicle-stimulating hormone during the human menstrual cycle.
BACKGROUND
The rise in FSH (FSHr) that leads to the recruitment of a cohort of follicles during the menstrual cycle occurs during the luteal-follicular transition, however, it is unclear whether it consistently occurs on one particular day, or is subjected to reproductive ageing.


METHODS
We determined the FSHr in 836 complete menstrual cycles from 102 women with regular menses using an algorithm, and additionally compared the relative variation in FSH during the last 14 days of the cycle. Possible effects of reproductive ageing on the onset of FSHr were also investigated.


RESULTS
The day of FSHr follows a normal distribution with a median value of -4 (relative to first day of menses), mean -4.1 and SD 2.1. Analysis of the relative changes in FSH during the last 14 days of the cycle revealed the first significant rise on day -4 (P=0.0033), coinciding with the first significant drop in estrogens (P=0.0002). No effect of chronological age, or initial FSH levels, on FSHr was found, however, there was an inverse relationship between total follicular phase length (from day of FSHr to LH peak) and initial FSH levels (P<0.0001).


CONCLUSIONS
The initial FSH rise in the cycle occurs consistently 4 days before menses, is related to a drop in estrogen levels, and is not affected by reproductive ageing.
Unipath Limited, Priory Business Park (FM), Bedford, MK44 3UP, UK. fernando.miro@unipath.com
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Miro
L J
LJ
Aspinall
D000328:Adult; D000375:Aging / Q000502:physiology / Q000652:urine; D004970:Estrone / Q000031:analogs & derivatives* / Q000652:urine; D005260:Female; D005640:Follicle Stimulating Hormone / Q000652:urine*; D005498:Follicular Phase / Q000652:urine; D006801:Humans; D008183:Luteal Phase / Q000652:urine; D008597:Menstrual Cycle / Q000652:urine*; D008875:Middle Aged; D006080:Ovarian Follicle / Q000502:physiology; D013997:Time Factors
C015856:estrone-3-glucuronide; D004970:Estrone; D005640:Follicle Stimulating Hormone