What Do Hormones Mean
As a patient you must have constantly heard the terms FSH, LH, E2 but have you ever tried to understand what they mean, to you or to your treatment? Lets try and understand them little better.
There is a centre called Pituitary at the base of the brain that produces two hormones FSH and LH besides various other hormones. FSH or Follicle Stimulating Hormone (as the name suggests), acts on a follicle which is still very small to helps to make it grow. These follicles are present in the ovary and ever month around the time of your periods, a few of them are recuited for subsequent growth. These follicles contain what will ultimately become a mature egg. Cells around the growing follicle produce the hormone E2 or Estradiol. Thus Estradiol levels are a measure of the growth of the egg. If this is understood, then its clear that in the beginning of the cycle (just when your periods start, maybe Day2), the Follicle is small therefore E2 is low and FSH is rising to flog the follicle into growing. As the follicle grows bigger, the E2 levels rise too and sometimes we use these values to find out if the medicines we are giving to make the eggs grow are adequate. By around Day 7 of your periods, the role of FSH in making the eggs grow, is supplemented by the hormone LH or Leutinizing Hormone. This hormone acts on the follicle and matures the egg and readies it for impending ovulation.
We check the maturity of the egg again by E2 levels which is usually 250pg/ml per mature follicle. Around mid cycle (approx Day 14 of your cycle), the LH values rise dramatically and trigger a series of events that ultimately result in rupturing the follicle and releasing the egg contained within. We can also do this artificially by giving injections of HCG (Ovutrig, Pregnyl, Ovidrel). Once the egg is released, the follicle (empty shell) becomes a Corpus Luteum and secretes Progesterone.
Therefore before follicle rupture, the Progesterone levels are <> 10ng/ml. This whole process is repeated every month and this simple physiology is utilized by us to manipulate the growth of the eggs and treat patients. I hope I have been able to make some aspects of this clear to you. Hope to hear some comments from you and ofcourse questions are always welcome.