Follicular-Stimulating Hormone (FSH) and Luteinizing Hormone (LH), Serum

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Subject: Follicular-Stimulating Hormone (FSH) and Luteinizing Hormone (LH), Serum

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Definition

  • These glycoproteins are produced by the anterior pituitary gland, regulated by hypothalamic gonadotropin-releasing hormone (GnRH) and feedback by gonadal steroid hormones. FSH stimulates follicular growth and stimulates seminiferous tubules and testicular growth. LH stimulates ovulation and production of estrogen and progesterone. LH controls production of testosterone by Leydig cells.

  • Normal range: see Table 16.34.

 
TABLE 16–34
Normal Ranges of Human FSH and LH

Use

  • Diagnosis of gonadal, pituitary, hypothalamic disorders

  • Diagnosis and management of infertility

Interpretation

Increased In

  • Primary hypogonadism (anorchia, testicular failure, menopause)

  • Gonadotropin-secreting pituitary tumors

  • Precocious puberty (secondary to a CNS lesion or idiopathic)

  • Complete testicular feminization syndrome

  • Luteal phase of menstrual cycle

Decreased In

  • Secondary hypogonadism

  • Kallmann syndrome (inherited X-linked or autosomal isolated deficiency of GnRH; occurs in both sexes) found in approximately 5% of patients with primary amenorrhea. Causes failure of both gametogenic function and sex steroid production (LH and FSH are “normal” or undetectable but rise in response to prolonged GnRH stimulation)

  • Pituitary LH or FSH deficiency

  • Gonadotropin deficiency

Limitations

  • Because of the episodic, circadian, and cyclic nature of its secretion, clinical evaluations may require determinations in pooled multiple serial specimens.

 
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