Testing Ovarian Function

Abstract

The two aspects of ovarian function—estrogen production and follicular maturation leading to ovulation—are highly interdependent phenomena. Since follicular maturation critically depends on several hormonal factors, a crucial one being the local (intraovarian) concentration of estradiol, it is perhaps correct to perceive estrogen production as the primary function of the ovary. Without adequate estrogen synthesis, follicular maturation will not occur, nor will the hormonal stage be set for ovulation, i.e., rupture of the mature Graafian follicle. Thus, the tests that evaluate adequacy of ovarian function can be viewed in terms of tests that are aimed at evaluating estrogen synthesis by the granulosa cells of the ovaries, tests that evaluate if ovulation has occurred, tests that evaluate the hypothalamo—pituitary axis, tests that evaluate uterine responsiveness to the changing sex-steroid milieu, and tests that evaluate the entire female genital tract for patency and suitability for sperm viability (Table 79).