HYPOTHALAMO-PITUITARY OVARIAN SYSTEM

HYPOTHALAMO PITUITARY OVARIAN (HPO) AXIS

Refers to the complex interactions between the hypothalamus, pituitary, and ovaries that regulate the reproductive cycle. These interactions are based on the interplay of the hormones released by these structures:
gonadotropin-releasing hormone (GnRH) gonadotropins follicle-stimulating hormone (FSH) and LH ovarian sex steroid hormones, estrogen and progesterone.

Through stimulatory and inhibitory actions, these hormones directly and indirectly:
stimulate oocyte development and ovulation endometrial development to facilitate embryo implantation menstruation.

COMPONENTS OF THE AXIS

HYPOTHALAMUS
pulsatile

GnRH
PITUITARY GLAND

LH
THE OVARIAN UNIT

FSH

ESTRADIOL PROGESTERONE

Positive feedback Negative feedback

HYPOTHALAMUS
At

the base of the brain (above the junction of optic nerves) Contain many nuclei:

Supraoptic, Paraventricular, Arcuate nuclei

It

secrete both:
Releasing (stimulating) factors:
Gn RH FSH & LH, TRH TSH CRH ACTH GH

Inhibiting factors
GHIF PRL inhibitory factor (dopamine)

Regulate the primitive functions needed for survival;

Appetite Temperature H2O retention Growth metabolism

Control of reproduction

It acts as transducer to convert neuronal pulses into release of Gn RH

With the onset of puberty, the hypothalamus start to produce (GnRH) in a pulsatile manner (every 1 - 2 hours) passes by the hypophyseal portal veins to the ant. lobe of pit. gland, where it causes release of the gonadotropins. The median eminence of hypothalamus can either stimulate or inhibit the secretion of the pituitary hormone The hypothalamus itself is influenced by other parts of the C.N.S (they respond to signals in the blood stream, as well as to neurotransmitters within the brain in a process known as neurosecretion).

PITUITARY GLAND

It is the leader of endocrine orchestra

Site: the middle cranial fossa occupying the pituitary fossa in the sella turcica :

Anterior lobe (adenohypophysis) :

secret gonadotropin (FSH & LH), prolactin, GH mostly cellular, very vascular and originate from Rathkes pouch. not normally receive arterial blood supply but it receives blood through hypophyseal portal circulation mostly fibrous, less vascular and developed as a down growing diverticulum from the diencephalons. produce oxytocin & vasopressin (ADH)

The posterior lobe (neurohypophysis) :

FEEDBACK OSCILLATION OF THE HPO AXIS

It is better to understood with the following sequence of 3 successive events:

Follicular growth phase Preovulatory surge of LH and FSH cause ovulation Postovulatory secretion of ovarian hormones and depression of pituitary gonadotropins

FOLLICULAR GROWTH PHASE

2 to 3 days before menstruation the corpus luteum regressed and it secretion of estrogen and progesterone decrease This release the NEGATIVE FEEDBACK effect of the hormones on hypothalamus and anterior pituitary Hence pituitary secretion of FSH and LH increase, and the recruitment of new ovarian follicles begin

During first 11 to 12 day, pituitary secretion of FSH and LH decrease because of NEGATIVE FEEDBACK effect of estrogen on anterior pituitary.

There is progressive increase in secretion of estrogen from these follicles especially on day 5 to 7

This lead to withdrawal of FSH support from other less developed follicle leading to atresia

Dominant follicle is capable of continued development in the face of falling FSH level

PREOVULATORY SURGE OF LH AND FSH CAUSE OVULATION

At about 11 to 12 days after the onset of monthly cycle decline in secretion of FSH and LH comes to an abrupt halt

High level of estrogen at this time cause peculiar POSITIVE FEEDBACK effect on anterior pituitary

This lead to terrific surge of secretion of LH and to lesser extent of FSH surge

Excess of LH leads to ovulation and subsequent development of corpus luteum

POSTOVULATORY SECRETION OF OVARIAN HORMONES AND DEPRESSION OF PITUITARY GONADOTROPINS

After ovulation, corpus luteum secrete large quantities of progesterone and estrogen

Cause suppression of FSH and LH secretion

NEGATIVE FEEDBACK on anterior pituitary and hypothalamus