CLASSIFICATION OF AMENORRHOEIC STATES AND THEIR TREATMENT BY OVULATION INDUCTION

Abstract

Ovulation is the result of an integrated action between the hypothalamus, pituitary and ovaries. A well-balanced interaction between the gonadotrophic hormones (mediated through the hypothalamus) and ovarian steroids leads to an orderly ovulatory sequence. The gonadotrophin-releasing hormone (GnRH) stimulates the synthesis and the secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH), which results in ovarian follicular growth and maturation. During the process of follicular maturation oestrogens and other steroids are produced which, in turn, appear to induce an LH and FSH surge responsible for ovulation by stimulating the hypothalamus and modulating the response of the pituitary to GnRH. Failure to ovulate may be the result of dysfunction at any level of this complex system, including higher centres in the brain, the hypothalamichypophyseal-ovarian axis and the steroid feedback mechanism.