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Dr SIVARAJ S
DEPT OF PHYSIOLOGY
ALL INDIA INSTITUTE OF MEDICAL SCIENCES
NEW DELHI
20/03/2013
 The mechanisms that trigger initiation of
follicular growth are still not completely
understood
 Thought to involve bidirectional
communication between germ and somatic
cells through gap junctions
 Paracrine factors : cytokines and growth
factors (insulin-like growth factor [IGF],
epidermal and fibroblast growth factors, and
interleukin-1).
Lange endocrine physiology 2ed
 FSH and insulin-like-growth factor (IGF)
enhance each other's ability to
stimulate follicle cell function
 Access of IGF II to their receptors is
regulated by IGF binding proteins and specific
proteases ascribed a role in DF development
Son WY et al. 2011
 Serum AMH level correlates with ovarian
follicle number
 AMH levels decline as the size of the follicle
increases
 In patients with polycystic ovary syndrome
(PCOS), AMH levels are elevated,
 Potential relevance in PCOS diagnosis and
management
 A useful clinical marker for the assessment of
ovarian reserve
Broekmans FJ et al.2008
Aromatase and Estradiol
Estradiol by DF
Granulosa cell proliferation in
non DF
DF= Dominant follicle
FSH in blood
 Healthy blood supply
 Accumulation of follicular fluid
 Increased density of FSH receptors on its
granulosa cells
 Accumulation of atretogenic androgens,such
as DHT in the non DF
 As the DF grows vascularization of the theca
layer increases
 More efficient delivery of cholesterol to theca
cells and better exposure to circulating
gonadotropins
Dominan Follicle selection in ovary

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Dominan Follicle selection in ovary

  • 1. Dr SIVARAJ S DEPT OF PHYSIOLOGY ALL INDIA INSTITUTE OF MEDICAL SCIENCES NEW DELHI 20/03/2013
  • 2.  The mechanisms that trigger initiation of follicular growth are still not completely understood  Thought to involve bidirectional communication between germ and somatic cells through gap junctions  Paracrine factors : cytokines and growth factors (insulin-like growth factor [IGF], epidermal and fibroblast growth factors, and interleukin-1). Lange endocrine physiology 2ed
  • 3.  FSH and insulin-like-growth factor (IGF) enhance each other's ability to stimulate follicle cell function  Access of IGF II to their receptors is regulated by IGF binding proteins and specific proteases ascribed a role in DF development Son WY et al. 2011
  • 4.  Serum AMH level correlates with ovarian follicle number  AMH levels decline as the size of the follicle increases  In patients with polycystic ovary syndrome (PCOS), AMH levels are elevated,  Potential relevance in PCOS diagnosis and management  A useful clinical marker for the assessment of ovarian reserve Broekmans FJ et al.2008
  • 5. Aromatase and Estradiol Estradiol by DF Granulosa cell proliferation in non DF DF= Dominant follicle FSH in blood
  • 6.  Healthy blood supply  Accumulation of follicular fluid  Increased density of FSH receptors on its granulosa cells  Accumulation of atretogenic androgens,such as DHT in the non DF
  • 7.  As the DF grows vascularization of the theca layer increases  More efficient delivery of cholesterol to theca cells and better exposure to circulating gonadotropins

Editor's Notes

  1. Suppression of plasma FSH in response to increased estradiol secretion by the dominant follicledecline in FSH support decreases aromatase activity and estradiol production and interrupts granulosa cell proliferation in those nondominant follicles