Luteinizing hormone–independent rise of progesterone as the physiological trigger of the ovulatory gonadotropins surge in the human

Dmitri I. Dozortsev, Michael P. Diamond

Research output: Contribution to journalReview articlepeer-review

Abstract

The current ovarian cycle paradigm postulates that ovulation is triggered by a critically sustained elevation of estradiol. However, an in-depth look into the published data reveals considerable uncertainty about the relative roles of progesterone and estradiol in the ovulation process.This review provides compelling evidences that the role of estradiol in ovulation has been misinterpreted and that the true physiological trigger of ovulation is a luteinizing hormone–independent preovulatory progesterone surge in the circulation to approximately 0.5 ng/mL. Furthermore, the current work reconciles the ability of progesterone to trigger ovulation, with its well-established ability to block ovulation during pregnancy, or when administered in the form of a synthetic progestin in birth control formulations and with experimental data that estradiol benzoate triggers ovulation in the complete absence of progesterone.

Original languageEnglish (US)
Pages (from-to)191-199
Number of pages9
JournalFertility and sterility
Volume114
Issue number2
DOIs
StatePublished - Aug 2020

Keywords

  • Gonadotropin surge
  • ovulation
  • progesterone

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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