the menstrual cycle

Question 1

the menstrual cycle

Answer 1

Follicular phase​

Hypothalamus-> gonadotropin-releasing hormone (GnRH). ​

Pituitary gland -> follicular stimulation hormone (FSH). ​

FSH stimulates follicles in the ovaries to grow and mature eggs.

Growing Follicle -> estrogen (E2)​

High estrogen->pituitary -> luteinizing hormone (LH) and FSH.

About 24 hours after the LH surge(peak)-> ovulation

Post ovulation-> corpus luteum (the empty follicle) produces progesterone/estradiol​

Luteal phase begins

Question 2

Estradiol (E2) - day 1-4 - what levels are normal?

(ester is pg)

Answer 2

<80 pg/ml

Question 3

Estradiol (E2) - day 5-14

Answer 3

100+ pg/ml​

(Rises in relation to growing follicles )

Question 4

Follicle Stimulating Hormone (FSH) - day 1-4

(I and U are follicles)

Answer 4

<10 IU/ml

Question 5

LH - day 1-4

Answer 5

<10 IU/ml

Question 6

LH - day 5-14

Answer 6

> 15 (surge) mIU/ml​

Depends on lab assay, etc..could be as low as >12 (most will be well about ~ >20 or higher

Question 7

progesterone (P4) - day 1-14

Answer 7

<1.5 ng/ml

Question 8

progesterone (P4) - after ovulation

(progy is 1 1/2 to 2 1/2)

Answer 8

> 2.5 ng/ml

Question 9

abnormal results E2 - day 1-4

Answer 9

> 100 pg/ml, causes - Functional Ovarian cyst, Perimenopause

Question 10

abnormal results E2 - day 1-4 - implications - think about what E2 does

Answer 10

Delayed treatment start​

Suppresses FSH level

Question 11

FSH - abnormal results - day 1-4

Answer 11

> 15 IU/ml - causes - Perimenopause​
Checked on day of LH surge

Question 12

FSH - abnormal results E2 - day 1-4 - implications

Answer 12

Decreased egg quality​

FSH invalid due to the normal surge on day of LH surge

Question 13

LH - abnormal results - greater than 15 - day 1-4, preovulatory

(lutenize my PCOS)

Answer 13

> 15 mIU/ml, causes - PCOS

Question 14

LH - abnormal results - 1-4, preovulatory

Answer 14

May advise false reading on OPK

Question 15

P4 - Luteal phase - abonormal results - less than 2.5 - and causes? (tested 7 days after ovulation)

(Progy is small)

Answer 15

<2.5 ng/ml - cause -Anovulation

Question 16

P4 - Luteal phase (tested 7 days after ovulation) low progesterone - treatment?

Answer 16

May need ovulation induction medication

Question 17

AMH​
(Anti-Mullerian Hormone

Answer 17

What is AMH?​

AMH (Anti-mullerian hormone) is protein released by small follicles in the ovaries. These “resting” or antral follicles contain immature eggs that can be stimulated to produce mature eggs that can be frozen or fertilized. ​

This bloodtest along with the AFC Ultrasound can help with ovarian reserve assessment.​

It also, helps the provider determine medication dosing for someone going through IVF/Egg Freezing; and help to give expectations on number of eggs one might anticipate at a future egg retrieval.

Question 18

AMH - high - the number

Answer 18

> 4.0

Question 19

AMH - normal

(AMH was a 1.5 earthquake)

Answer 19

1.5-4.0

Question 20

AMH - low normal

Answer 20

1.0-1.5

Question 21

AMH - low

Answer 21

0.5-1.0

Question 22

AMH - very low

Answer 22

<0.5