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Dominan Follicle selection in ovary

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Dominan Follicle selection in ovary

  1. 1. Dr SIVARAJ SDEPT OF PHYSIOLOGYALL INDIA INSTITUTE OF MEDICAL SCIENCESNEW DELHI20/03/2013
  2. 2.  The mechanisms that trigger initiation offollicular growth are still not completelyunderstood Thought to involve bidirectionalcommunication between germ and somaticcells through gap junctions Paracrine factors : cytokines and growthfactors (insulin-like growth factor [IGF],epidermal and fibroblast growth factors, andinterleukin-1).Lange endocrine physiology 2ed
  3. 3.  FSH and insulin-like-growth factor (IGF)enhance each others ability tostimulate follicle cell function Access of IGF II to their receptors isregulated by IGF binding proteins and specificproteases ascribed a role in DF developmentSon WY et al. 2011
  4. 4.  Serum AMH level correlates with ovarianfollicle number AMH levels decline as the size of the follicleincreases In patients with polycystic ovary syndrome(PCOS), AMH levels are elevated, Potential relevance in PCOS diagnosis andmanagement A useful clinical marker for the assessment ofovarian reserveBroekmans FJ et al.2008
  5. 5. Aromatase and EstradiolEstradiol by DFGranulosa cell proliferation innon DFDF= Dominant follicleFSH in blood
  6. 6.  Healthy blood supply Accumulation of follicular fluid Increased density of FSH receptors on itsgranulosa cells Accumulation of atretogenic androgens,suchas DHT in the non DF
  7. 7.  As the DF grows vascularization of the thecalayer increases More efficient delivery of cholesterol to thecacells and better exposure to circulatinggonadotropins

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