Evidence for a critical role of progesterone in the regulation of the midcycle gonadotropin surge and ovulation

J Clin Endocrinol Metab. 1992 Mar;74(3):565-70. doi: 10.1210/jcem.74.3.1740491.

Abstract

Serum concentrations of progesterone begin to rise just before the midcycle gonadotropin surge that leads to ovulation. To examine the role of progesterone in the regulation of these events, we evaluated the effects of a low dose (1 mg/day, orally) of the antiprogesterone RU 486 on the timing of the gonadotropin surge and ovulation in normally cycling women. The drug or a placebo was given for 5 or 15 days, starting when the dominant follicle reached 14-16 mm. RU 486 consistently delayed the timing of the midcycle gonadotropin surge and the subsequent collapse of the dominant follicle, despite rising estradiol concentrations and normal follicular development. Unexpectedly, RU 486 also delayed the emergence of the periovulatory progesterone rise. The addition of progesterone (5-10 mg/day, im, for 2 days) to a 5-day course of RU 486 after the emergence of a mature follicle readily induced LH and FSH surges and completely reversed the effects of RU 486 at midcycle. Our results suggest that RU 486 delays the midcycle gonadotropin surge and ovulation by suppressing or antagonizing an ovarian progestational signal. Progesterone may, thus, represent the ultimate ovarian signal to the estrogen-primed hypothalamic-pituitary unit to trigger the gonadotropin surge that leads to ovulation.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Follicular Phase / drug effects
  • Humans
  • Luteal Phase / drug effects
  • Luteinizing Hormone / blood
  • Menstrual Cycle / drug effects*
  • Menstrual Cycle / physiology
  • Mifepristone / pharmacology*
  • Ovarian Follicle / drug effects
  • Ovarian Follicle / physiology
  • Progesterone / blood
  • Progesterone / metabolism*
  • Progesterone / pharmacology
  • Reference Values

Substances

  • Mifepristone
  • Progesterone
  • Estradiol
  • Luteinizing Hormone
  • Follicle Stimulating Hormone