- Follicle-stimulating hormone
Follicle-stimulating hormone (FSH) is a
hormonesynthesized and secreted by gonadotropes in the anterior pituitary gland. FSH regulates the development, growth, pubertal maturation, and reproductive processes of the human body. FSH and Luteinizing hormone(LH) act synergistically in reproduction:
*In females, in the
ovaryFSH stimulates the growth of immature Graafian follicles to maturation. Graafian follicles are the mature follicle. Primary follicles mature to Graafian follicles. As the follicle grows, it releases inhibin, which shuts off the FSH production.
*In males, FSH enhances the production of
androgen-binding proteinby the Sertoli cells of the testes, and is critical for spermatogenesis.
FSH is a
glycoprotein. Each monomeric unit is a protein molecule with a sugar attached to it; two of these make the full, functional protein. Its structure is similar to those of LH, TSH, and hCG. The protein dimer contains 2 polypeptideunits, labeled alpha and beta subunits. The alpha subunits of LH, FSH, TSH, and hCG are identical, and contain 92 amino acids. The beta subunits vary. FSH has a beta subunit of 118 amino acids (FSHB), which confers its specific biologic action and is responsible for interaction with the FSH-receptor. The sugar part of the hormone is composed of fucose, galactose, mannose, galactosamine, glucosamine, and sialic acid, the latter being critical for its biologic half-life. The half-life of FSH is 3-4 hours.Its molecular wt is 30000.
The gene for the alpha subunit is located on chromosome 6p21.1-23. It is expressed in different cell types. The gene for the FSH beta subunit is located on chromosome 11p13, and is expressed in gonadotropes of the pituitary cells, controlled by
GnRH, inhibited by inhibin, and enhanced by activin.
FSH regulates the development, growth, pubertal maturation, and reproductive processes of the human body.
* In both "males" and "females", FSH stimulates the maturation of
* In "males", FSH induces
sertoli cellsto secrete inhibinand stimulates the formation of sertoli-sertoli tight junctions ( zonula occludens).
* In "females", FSH initiates follicular growth, specifically affecting granulosa cells. With the concomitant rise in inhibin B, FSH levels then decline in the late follicular phase. This seems to be critical in selecting only the most advanced follicle to proceed to ovulation. At the end of the luteal phase, there is a slight rise in FSH that seems to be of importance to start the next ovulatory cycle.
Like its partner, LH, FSH release at the pituitary gland is controlled by pulses of
gonadotropin-releasing hormone(GnRH). Those pulses, in turn, are subject to the oestrogen feed-back from the gonads.
FSH levels are normally low during
childhoodand, in females, high after menopause.
High FSH levels
High levels of Follicle-Stimulating Hormone are indicative of situations where the normal restricting feedback from the gonad is absent, leading to an unrestricted pituitary FSH production. Whereas this is normal in females leading up to and during postmenopause, it is abnormal during the reproductive years.
If the FSH level is high during the reproductive years, this may be a sign of:
Premature menopausealso known as Premature Ovarian Failure
Gonadal dysgenesis, Turner syndrome
# Certain forms of
# Testicular failure.
Low FSH levels
Diminished secretion of FSH can result in failure of gonadal function (hypogonadism). This condition is typically manifest in males as failure in production of normal numbers of sperm. In females, cessation of reproductive cycles is commonly observed.Conditions with very low FSH secretions are:
# Gonadal suppression therapy
GnRH agonist( downregulation).
FSH is available mixed with LH in the form of
Pergonalor Menopur, and other more purified forms of urinary gonadotropins, as well as in a pure forms as recombinant FSH (Gonal F, Follistim). It is used commonly in infertility therapy to stimulate follicular development, notably in IVFtherapy, as well as with interuterine insemination (IUI).
* [http://infertilityblog.blogspot.com/2006/03/first-of-few-about-fsh-levels.html Day 3 FSH levels] From the Infertility Blog by Dr. Fred Licciardi
* [http://infertilityblog.blogspot.com/2006/03/high-fsh-excuse-to-send-patients-away.html High FSH: an excuse to send patients away] From the Infertility Blog by Dr. Fred Licciardi
* [http://infertilityblog.blogspot.com/2006/03/fsh-and-estradiolestrogen.html FSH and Estradiol]
* [http://www.thefertilesoul.com/Treatment/Imbalances/fsh.php Causes & Symptoms of High FSH]
* [http://www.highfshinfo.com Information on high FSH compiled by a woman with high FSH]
* [http://maybebaby.ctwfeatures.com Debating the imbalance as a cause of one couple's infertility]
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