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La Rivista Italiana della Medicina di Laboratorio 2022 Jul 08

DOI: 10.23736/S1825-859X.22.00147-5

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: Italian

Pituitary gonadotropins and infertility

Ottavia PORZIO

UOC Laboratorio Analisi Cliniche, Dipartimento di Medicina Sperimentale, IRCCS Ospedale Pediatrico Bambino Gesù, Università degli studi di Roma Tor Vergata, Roma, Italia


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Gonadotropins regulate gonadal function by promoting the production of sex steroids and gametogenesis. Their secretion is under the control of the gonadotropin releasing factor (GnRH) from the 20th week of gestation. At the time of puberty, the activation of the pulsatility of GnRH determines the incretion of gonadotropins, resulting in a marked increase in the LH/FSH ratio. In women during the fertile age, the secretion of FSH and LH is cyclical and regulates the menstrual cycle; in males, LH stimulates the production of testosterone from the Leydig cells of the testis while FSH stimulates the tubular component of the Sertoli cells, contributing to the regulation of spermatogenesis. The assay of gonadotropins finds its main clinical application in the study of hypogonadotropic or hypergonadotropic hypogonadism, in precocious puberty, in polycystic ovary syndrome (PCOS) and in the evaluation of ovarian reserve. In the clinical setting, only automatic 'sandwich' immunometric methods are used, which are quick, accurate, specific and highly sensitive. Their calibration is complex, because it is not possible to produce calibrators that reflect the heterogeneity of the LH and FSH circulating molecules: the most widely used international standards for the calibration are the 2° IRP 78 / 549 for FSH and 2° IS 80/552 for LH. Although the cross-reactivity towards the β subunit of LH and FSH is currently <1%, it is important to remind that different analytical methods can give different values of more than 50%, even when calibrated with the same reference material.


KEY WORDS: Luteinizing hormone (LH); Follicle-stimulating hormone (FSH); Hypogonadism; Puberty

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