高黄体生成素水平与早发黄体生成素峰的概念

The concepts of high luteinizing hormone level and premature luteinizing hormone surge

黄体生成素（1uteinizing hormone，LH）是由垂体前叶促性腺激素（gonadotropin，Gn）细胞合成分泌的糖蛋白激素。LH的分泌呈脉冲式，受下丘脑促性腺激素释放激素（gonadotropin releasing hormone，GnRH）、卵巢雌激素、孕激素和抑制素的综合调节。由下丘脑神经元释放的GnRH刺激垂体Gn细胞释放LH和卵泡刺激素（follicle—stimulating hormone，FSH），同时Gn和GnRH的释放也受卵巢的雌激素和孕激素正负反馈调控。

An appropriate level of luteinizing hormone （LH） is necessary for normal follicle and oocyte development. If the follicles expose to an inappropriately high concentration of LH （beyond a certain ceiling level）, it will result in the suppression of granulose proliferation, nondominant follicles atresia, premature luteinization of preovulatory follicles and the compromised oocytes development. The inappropriately high LH level can increase circulating androgens produced by ovarian theca cell, which leads to an increased incidence of the high ovarian response to stimulation. The premature LH surge is defined as an LH surge occurring before the criteria of the mature follicle or the criteria of hCG administration is met. The premature LH surge can lead to early ovulation and premature luteinization, increasing the cycle cancellation rate and decreasing the pregnancy rate. The premature LH surge is thought to be related to the ovarian gonadotrophin surge-attenuating factor （GnSAF）.