Quality Assessment

As described earlier in this chapter, FSH, LH, and estradiol levels fluctuate dramatically during the ovulatory cycle of a normal adult female. In an average 28-day cycle, FSH levels begin to rise by day three, stimulating the ovary to release estradiol and the pituitary to release LH. These hormones stimulate ovulation at mid-cycle and development of the corpus luteum for potential fertilization. Usually at midcycle, there is a peak of circulating FSH, LH, and estradiol concentrations as well as increased clinical signs of ovulation, such as a slight increase in basal body temperature and cervical mucus production. It is generally a complex interaction of hormones and physical changes that allow for ovulation and then fertilization of an oocyte by sperm. Fertility testing involves assessing many of these aspects. Test Methodologies 12-4 and 12-5 describe methods of analysis for LH and FSH, respectively.

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