REPRODUCTIVE HORMONES

Testes and Ovaries

These produces sex steroids from cholesterol through the same pathway utilized in the adrenal glands.

Androgens and Estrogens

These are known as sex steroids.

• Testosterone to estradiol

• Androstenedione to estrone

What conversions occur in the ovary?

• Testosterone to dihydrotestosterone

• Hydroxylate estradiol to estriol

What reductions occur in the peripheral tissue?

• Adrenal androgens to testosterone

• Androgens to estrone & estradiol

What conversions occur in the peripheral tissue?

1. Sex hormone-binding globulin

2. Corticosteroid-binding globulin

3. Albumin

What are the major transport proteins?

SHBG

A transport protein that delivers estrogen and androgen.

CBG

A transport protein that delivers progesterone and glucocorticoids.

Free fraction/form of Hormones

A type of hormone is biologically active that can diffuse into the vascular system and interact with target cells.

Testosterone

A C-19 steroid hormone synthesized by the Leydig cells of the testis.

Testosterone

It is the principal androgen hormone in the blood.

Testosterone

It is the most potent male androgen, derived from progesterone, and controlled by the luteinizing hormone.

8 to 10 AM

When is the best time to testosterone sample?

Male = 300 to 1200 ng/dL

Female = 30 to 95 ng/dL

Reference value for Testosterone

Circadian Pattern

• peaks at 8 AM

• lowest level at 8 PM

Age

• After 30 yrs. of age = decline of about 110 ng/dL

• Male older than 50 yrs. = decreased testosterone

• Female older than 50 yrs. = increased FSH, decreased estrogen

Obesity = decreased plasma testosterone concentration

Factors affecting testosterone levels

1. Pre-testicular Infertility (Secondary Hypogonadism)

2. Testicular Infertility (Primary Hypogonadism)

3. Post-testicular (Tertiary Hypogonadism)

Types of testicular infertility (hypogonadism)

Pre-testicular Infertility

A testicular infertility due to hypothalamic or pituitary lesions.

Testicular Infertility

Based on the result below, what type of hypogonadism is referred to?

• Decreased testosterone

• Increased FSH and LH

Post-testicular Infertility

A testicular infertility due to disorders of sperm transport and function.

Secondary Hypogonadism

Based on the result below, what type of hypogonadism is referred to?

• Normal or decreased testosterone, FSH, and LH

Tertiary Hypogonadism

Based on the result below, what type of hypogonadism is referred to?

• Normal testosterone, FSH, and LH

Dehydroepiandrosterone

it is the principal androgen formed by the adrenal cortex.

Dehydroepiandrosterone

It also referred to as the weak androgen.

Dehydroepiandrosterone

This hormone is valuable in the assessment of adrenal cortical function.

Follicle-stimulating hormone (FSH)

• Stimulates growth of the ovarian follicles

• Increases the plasma estrogen levels

• Controlled by the gonadotropin-releasing hormone

Luteinizing Hormone (LH)

• Stimulates production of progesterone at ovulation

• Controlled by the gonadotropin-releasing hormone

Abnormal synthesis of estrogen

Caused by primary disorder of the ovaries or as a secondary disorder due to a primary disorder of the pituitary of hypothalamus.

Estrogen and Progesterone

These are the principal female sex hormones.

• Estrone

• Estradiol

• Estradiol-17beta

Three primary estrogens

Estradiol

It is the principal estrogen synthesized by the ovaries.

Estrogen

• Promotes development and maintains the female reproductive system, including the uterus, fallopian tubes, and vagina

• Responsible for the development and maintenance of secondary female sex characteristics: breast development, maturation of external genetalia, fat deposition, and termination of bone growth

Progesterone

• Secreted by the corpus luteum

• Secreted by the placenta to maintain the uterus

1. First-half (7 days): FSH promotes growth of ovarian follicles and increase estrogen levels

2. Mid-cycle (14 days): estrogen peaks, decreased FSH, LH surge

3. Ovulation is triggered by LH: estrogen and LH decreases

4. Follicles becomes corpus luteum producing estrogen and progesterone

5. Menstruation begins

What happens in the menstrual cycle?

• Absence of human chorionic gonadotropin

• Decreased estrogen and progesterone

What occurs if there is lack of fertilization?

Follicular Phase

• It is the first-half of the cycle

• Estrogen stimulates uterine lining growth

• Progesterone levels are low

Luteal Phase

• It is the second half of the cycle

• Progesterone promotes endometrium tissue to accept the fertilized ovum

Estrogen

A carbon-18 steroid hormone that have a phenol A ring.

Estrogen

It arises through structural alteration of the testosterone molecule and is not produced by the ovaries after menopause.

• Acetate

• Cholesterol

• Progesterone

• Testosterone

What are the precursor of Estrogen?

Estrone and Estriol

These are metabolites of intraovarian and extraglandular conversion.

1. Estrone

2. Estrdiol

3. Estriol

4. Estetrol

What are the forms of estrogen?

Estrone (E1)

The most abundant estrogen in post-menopausal women.

Estradiol (E2)

it is used to assess ovarian function and serves as a negative feedback for FSH.

Estriol (E3)

A metabolite of estradiol.

Estriol (E3)

The major estrogen secreted by the placenta during pregnancy.

Estriol (E3)

Used to assess the fetoplacental viability, post-date gestation, and intrauterine retardation.

Estriol (E3)

Marker for down syndrome.

Estetrol (E4)

A natural steroid produced by the human fetal liver consisting of 4 -OH groups.

Progesterone

A carbon-21 steroid hormone produced mainly by the granulose (lutein) cells of the corpus luteum.

Progesterone

Prime secretory product of the ovary, including estrogen.

Progesterone

The dominant hormone responsible for the luteal phase cycle.

Progesterone

• Used for fertility evaluation

• Prepare the uterus for pregnancy

• Prepare the lobules of the breast for lactation

• An intermediate in the synthesis of adrenal steroids and androstenedione

Failure of implantation of embryo

What results in the deficiency of progesterone?

Irregular and incomplete development of the endometrium

What results in the deficiency of estrogen?

Poor ovarian reserve

High estradiol levels result in

Abnormal pregnancy

Low progesterone levels results in

1. Pregnanediols

2. Pregnanediones

3. Pregnanalones

Three metabolites of progesterone

Pregnanediols

Progesterone metabolite that is most easily measured.

Test for male infertility

These are tested for what particular function?

• testosterone

• FSH and LH

• Semen analysis

Test for female infertility

These are tested for what particular function?

• Estradiol

• Progesterone

• HCG

• PRL

• FT4

• TSH

• FSH & LH

Test for seminal fluid fructose

These are tested for what particular function?

• testosterone, FSH, and LH = NORMAL

With oligospermia and azoopermia

Test for seminiferous tubule failure

These are tested for what particular function?

• testosterone and LH = NORMAL

• FSH = HIGH

With possible oligospermia

Test for partial or complete androgen insufficiency

These are tested for what particular function?

• testosterone and LH = HIGH

• FSH = NORMAL/HIGH

Test for menstrual cycle dysfunction and anovulation

These are tested for what particular function?

• Estrogen

• Progesterone

• FSH & LHTEST

Test for ovulation failure

These are tested for what particular function?

• FSH (day 3 follicular phase) & E2 = HIGH

Estradiol (E2)

It is the most potent estrogen secreted by the ovary, considered the major estrogen.

Estradiol (E2)

The most abundant estrogen in pre-menopausal women.