Crucial Role of Serum Human Chorionic Gonadotropin for the Aggravation of Thyrotoxicosis in Early Pregnancy in Graves' Disease

For most women, pregnancy is suspected when the symptoms of early pregnancy develop—these include breast soreness or tenderness, fatigue, nausea, and missed menses. Human chorionic gonadotropin (hCG) is first detectable using sensitive tests in the urine and blood of pregnant women 8–10 days after conception (day 22–24 of a 28-day menstrual cycle). Concentrations of hCG rise rapidly in early pregnancy, peak at 9–10 weeks, and decline thereafter to a nadir at 20 weeks. Understanding embryo-foetal development and maternal physiological accommodation to pregnancy is required for the optimal management of pregnancy in women with autoimmune diseases. This chapter reviews the important developmental and physiologic aspects of normal pregnancy and both common and unique obstetric complications associated with selected rheumatic conditions.

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Human Chorionic Gonadotropin and the Diagnosis of Early Pregnancy

Management of Common Problems in Obstetrics and Gynecology ◽

10.1002/9781444323030.ch96 ◽

2010 ◽

pp. 426-428

Author(s):

Rene B. Allen ◽

Mario J. Pineda ◽

Frank Z. Stanczyk ◽

Richard J. Paulson

Keyword(s):

Chorionic Gonadotropin ◽

Early Pregnancy ◽

Human Chorionic Gonadotropin

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Selection of fewer dominant follicles in Trio carriers given GnRH antagonist and luteinizing hormone action replaced by nonpulsatile human chorionic gonadotropin†

Biology of Reproduction ◽

10.1093/biolre/ioaa167 ◽

2020 ◽

Vol 103 (6) ◽

pp. 1217-1228

Author(s):

Victor E Gomez-León ◽

João Paulo Andrade ◽

Brian W Kirkpatrick ◽

Sadrollah Molaei Moghbeli ◽

Alvaro García-Guerra ◽

...

Keyword(s):

Luteinizing Hormone ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Gnrh Antagonist ◽

Maximum Diameter ◽

High Fecundity ◽

Follicle Diameter ◽

Follicle Selection ◽

Selection Of

Abstract Studying selection of multiple dominant follicles (DFs) in monovulatory species can advance our understanding of mechanisms regulating selection of single or multiple DFs. Carriers of the bovine high fecundity Trio allele select multiple DFs, whereas half-sib noncarriers select a single DF. This study compared follicle selection during endogenous gonadotropin pulses versus during ablation of pulses with Acyline (GnRH antagonist) and luteinizing hormone (LH) action replaced with nonpulsatile human chorionic gonadotropin (hCG) treatment in Trio carriers (n = 28) versus noncarriers (n = 32). On Day 1.5 (Day 0 = ovulation), heifers were randomized: (1) Control, untreated; (2) Acyline, two i.m. doses (Days 1.5 and D3) of 3 μg/kg; (3) hCG, single i.m. dose of 50 IU hCG on Day 1.5 followed by daily doses of 100 IU; and (4) Acyline + hCG. Treatments with nonpulsatile hCG were designed to replace LH action in heifers treated with Acyline. Acyline treatment resulted in cessation of follicle growth on Day 3 with smaller (P < 0.0001) maximum follicle diameter in Trio carriers (6.6 ± 0.2 mm) than noncarriers (8.7 ± 0.4 mm). Replacement of LH action (hCG) reestablished follicle diameter deviation and maximum diameter of DFs in both genotypes (8.9 ± 0.3 mm and 13.1 ± 0.5 mm; P < 0.0001). Circulating follicle stimulating hormone (FSH) was greater in Acyline-treated than in controls. Finally, Acyline + hCG decreased (P < 0.0001) the number of DFs from 2.7 ± 0.2 to 1.3 ± 0.2 in Trio carriers, with most heifers having only one DF. This demonstrates the necessity for LH in acquisition of dominance in Trio carriers (~6.5 mm) and noncarriers (~8.5 mm) and provides evidence for a role of GnRH-induced FSH/LH pulses in selection of multiple DFs in Trio carriers and possibly other physiologic situations with increased ovulation rate.

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