Components of Sex Hormone Profile Test- Part 2

Overview

One of the gonadotrophic hormones is the folicle-stimulating hormone, whereas the other is the luteinising hormone. Both are released into the bloodstream by the pituitary gland also known as the “master” gland. Follicle-stimulating hormone is a hormone that is necessary for pubertal development and the function of both women’s and men’s ovaries and testes. This hormone increases the growth of ovarian follicles in the ovary in women before ovulation when an egg is released from one follicle. It also promotes the production of estradiol. Follicle-stimulating hormone stimulates sperm production in men by acting on the Sertoli cells of the testes (spermatogenesis).

FSH levels can be employed for the following reasons:

For females:

• Infertility is a condition of the male or female reproductive system defined as the inability to conceive followed by a period of unprotected sexual activity of 12 months or more.
• Periods which have been missed, delayed, or unpredictable, as well as abnormal bleeding patterns; A heavy menstrual flow, a cycle that lasts longer than seven days, or bleeding or spotting between periods are all indications of abnormal uterine bleeding.
• Perimenopause, which means “around menopause,” is the period in which the body goes through the natural process of transitioning to menopause, which signifies the end of the reproductive years. The menopausal transition is also known as perimenopause. Perimenopause strikes women at various ages.

For males:

• In the condition of infertility, low sperm production, poor sperm function, or sperm delivery obstructions can all contribute to male infertility. Male infertility can be caused by illnesses, injuries, persistent health issues, lifestyle choices, and other causes.
• If the sexual desire has decreased (low libido).

Biological effects

Effects in females

FSH stimulates the proliferation and recruitment of immature ovarian follicles in the ovary. FSH is a critical survival factor in early (small) antral follicles, preventing apoptosis (A form of cell death in which a cell dies as a result of a sequence of molecular pathways. This is one of the mechanisms that the body gets rid of the unwanted or malfunctioning cells). In these small follicles (2–5 mm in diameter in humans) (programmed death of the somatic cells of the follicle and oocyte). FSH peaks around day three because blood levels of progesterone and oestrogen (mostly estradiol) diminish during the luteal-follicle phase transition period and no longer constrain FSH release (day one is the first day of menstrual flow). The number of small antral follicles in the cohort is usually sufficient to produce enough Inhibin B to lower FSH levels in the blood.

Furthermore, evidence suggests that the gonadotropin surge-attenuating factor produced by small follicles during the first half of the follicle phase has a negative feedback on the amplitude of pulsatile luteinizing hormone (LH) secretion, allowing for more preferable follicle growth and preventing premature luteinization.

As a woman approaches perimenopause, the number of small antral follicles recruited in each cycle declines, and as a result, insufficient Inhibin B is produced to completely suppress FSH, and the blood level of FSH begins to rise. After menopause, FSH levels rise to the point where FSH receptors are downregulated, and any remaining microscopic secondary follicles lack FSH or LH receptors.

The follicle begins to secrete considerable amounts of oestrogen when it reaches a diameter of 8–10 mm. Only one follicle becomes dominant in humans, growing to a size of 18–30 mm and ovulating, while the rest of the follicles in the cohort undergo atresia. The brain and pituitary benefit from the rapid rise in estradiol synthesis by the dominant follicle, resulting in rapid Gonadotropin-releasing hormone (GnRH) pulses and an LH surge.

An increase in serum estradiol levels causes a decrease in FSH output by inhibiting GnRH production in the hypothalamus.

The current cohort experiences atresia as a result of the decrease in blood FSH levels because their smaller follicles lack sufficient sensitivity to FSH. Because

both follicles are equally sensitive to FSH, they survive and mature in the low FSH environment, resulting in two ovulations in one cycle, potentially leading to non-identical (dizygotic) twins.

Effects in males

FSH causes primary spermatocytes to divide for the first time, resulting in secondary spermatocytes.

By binding to FSH receptors on their basolateral membranes, FSH increases the production of androgen-binding protein in the Sertoli cells of the testes, which is crucial for spermatogenesis.

Reference ranges

FSH levels in adults vary based on their age and gender.

In females:

• 0-4.0 milli-international units per millilitre following puberty
• 0.3-10.0 milli-international units per millilitre during adolescence
• Females who are still on their menstrual cycle 4.7-21.5 milli-international units per millilitre
• Postmenopause, 25.8-134.8 milli-international units per millilitre

In males:

• 0 to 5.0 milli-international units per millilitre (0 to 5.0 International units per litre) pre-puberty
• 0.3 to 10.0 milli-international units per millilitre (0.3 to 10.0 International units per litre) during puberty
• 1.5 to 12.4 milli-international units per millilitre (1.5 to 12.4 International units per litre) for adults

Author

Yash Batra