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Geneva, Switzerland, WHO, 1965. 19 p. (WHO Technical Report Series No. 304)This WHO technical report focuses on the 1) psychosomatic factors in human reproduction; 2) hypothalamo-hypophyseal system; 3) mechanism of sexual rhythm; 4) nervous influences on the hypothalamus; 5) hormonal influences on the hypothalamus; 6) neuroendocrine aspects of sexual behavior; and 7) effects of drugs on reproduction. After summarizing current research status on the above-mentioned topics, the following research needs are suggested: 1) assays of individual human endogenous gonadotropins, suitable for clinical application; 2) autoradiography, fluorescent-antibody, spectrophometric interference and histochemical and biochemical techniques for studying cells that supply axons to the primary capillary plexus of the hypophyseal portal system and for studying effects of different hormonal status on hypothalmic structure and function; 3) computer techniques for evaluating electrophysiological data; 4) improved lesioning techniques; 5) comparative studies of reproductive activity patterns, exteroceptive factors, neuroendocrine factors in sexual and related social behavior, and long-term or delayed effects of drugs administered during gestation on subsequent sexual development; 6) studies of synaptic connections of hypothalamic neurones; 7) studies of endogenous gonadal and gonadotropin production in prepuberal animals; 8) functional significance of regional distribution of hypophyseal portal system; 9) mechanisms involved in selective uptake of labeled hormones; 10) hypothalamic lesions in species with spontaneous ovulation and active luteal function; 11) direct effect of gonadal hormones on single hypothalamic neurones studied with combination of microinjection and unit recording devices; 12) studies of the possibility of a direct feedback of gonadotropic hormones on the hypothalamus; 13) studies of the receptor mechanisms involved in neuroendocrine reflexes; 14) wider exploration of brain structures, with regard to feedback action of gonadal hormones; 15) studies of pineal function; 16) further investigation of a possible role of the peripheral autonomic pathways in reproductive processes; and 17) research on the application of tissue culture techniques for studying problems of the origin and metabolic effects of neurohormonal mediators and the biochemcial and morphological changes induced by sex hormones.
In: Diczfalusy, E., ed. Regulation of human fertility. (Proceedings of the WHO Symposium on Advances in Fertility Regulation, Moscow, USSR, November 16-19, 1976) Copenhagan, Denmark, Scriptor, 1977. p. 21-71This chapter reviews the hormonal changes which occur during the menstrual cycle. During the last days of the preceeding menstrual cycle, plasma levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) increase. Follicular phase is characterized by gradually increasing estrogens. A few days preceding the LH surge, some little understood changes in estradiol, LH, and 17-hydroxyprogesterone, on one hand, and ACTH, cortisol, and aldosterone, on the other, occur. Evidence indicates that the estradiol peak occurs first, followed by a simultaneous rise and fall in LH and 17-hydroxyprogesterone values. The peak period of LH is about 32-44 hours long, during which time a rise in progesterone levels takes place. Other pituitary and steroid hormones (human chorionic gonadotropin, ACTH, prolactin, testosterine, androstenedione, cortisol, and aldosterone) show elevated levels during the periovulatory period. Ovulation occurs 16-48 hours after LH peak. The period following LH surge is characterized by rapidly increasing levels of progesterone, 17-hydroxyprogesterone, and 20-alpha-dihydroprogesterone, accompanied by moderately increasing estrogen levels to form the typical luteal-phase hormonal pattern. A luteal increase occurs also in levels of several other hormones, ranging from renin activity to angiotension, or from pregninolone to aldosterone. The last part of the luteal phase is characterized by rapidly declining levels of peripheral hormones. The perimenstrual phase around onset of heavy bleeding is characterized by gradually decreasing levels of progesterone, 20-alpha-hydroprogesterone, estradiol, and testosterone, associated with an incipient rise in LH and FSH levels.