Our understanding of the regulation of the menstrual cycle has recently improved with the development of various tools of investigation. The cycle is now thought to be determined mainly by the ovary itself, which sends various signals to the pituitary and the hypothalamus. The aim of the cycle is to produce a single mature oocyte each month from puberty to menopause. However, the most common evolution of a follicle is atresia, a consequence of the genetically controlled, ovarian apotosis (or "programmed cell death"). Follicular growth and maturation are mostly independent of gonadotropins, from the stage of primordial follicles to antral follicles. A complete intraovarian paracrine system is implied in this gonadotropin-independent follicular growth, and in the modulation of the actions of the gonadotropins in the ovary. FSH allows the rescue of a minority of follicles from atresia and is indispensable to only the final maturation of the preovulatory follicle. The cyclical variations of the gonadotropins are under the control of ovarian steroids (estradiol and progesterone) and peptides (inhibin). The cycle length is determined by follicular growth and by the fixed life span of the corpus luteum. The mechanism of action of gonadotropins is much better understood since the gonadotropins and their receptor cDNA have been cloned. The recent description of naturally occurring mutations has lead to a better understanding of the role of each gonadotropin, demonstrating the crucial role of FSH in the terminal maturation of the follicles. The ovarian cycle can also be monitored at the level of target tissues of steroids such as the endometrium. The cellular mechanisms of endometrial maturation, under the control of estradiol and progesterone, are better understood. The endometrial maturation is synchronized to follicular development and allows implantation of the conceptus. The genes implied in the implantation of the embryo are being identified (e.g., integrins). Last but not least, the mechanisms of endometrial shedding are being elucidated, especially the role of metalloproteases and angiogenic factors. These concepts will allow the development of new treatments for infertility, the design of new contraceptive techniques, and a better tolerance of treatments using sex steroids, particularly progestin-only pill.

中文翻译：

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人类月经周期的调节

随着各种调查工具的发展，我们对月经周期调节的理解最近有所改善。现在认为这个周期主要由卵巢本身决定，它向垂体和下丘脑发送各种信号。该周期的目标是从青春期到更年期每个月产生一个成熟的卵母细胞。然而，卵泡最常见的进化是闭锁，这是遗传控制的卵巢细胞凋亡（或“程序性细胞死亡”）的结果。从原始卵泡到窦卵泡阶段，卵泡的生长和成熟大多不依赖促性腺激素。这种不依赖促性腺激素的卵泡生长和卵巢中促性腺激素作用的调节暗示着一个完整的卵巢内旁分泌系统。FSH 允许从闭锁中拯救少数卵泡，并且对于排卵前卵泡的最终成熟是必不可少的。促性腺激素的周期性变化受卵巢类固醇（雌二醇和孕酮）和肽（抑制素）的控制。周期长度由卵泡生长和黄体的固定寿命决定。由于已经克隆了促性腺激素及其受体 cDNA，因此对促性腺激素的作用机制有了更好的了解。最近对自然发生的突变的描述使人们更好地了解了每种促性腺激素的作用，证明了 FSH 在卵泡终末成熟中的关键作用。卵巢周期也可以在类固醇的靶组织水平上进行监测，例如子宫内膜。在雌二醇和孕酮的控制下，子宫内膜成熟的细胞机制得到了更好的理解。子宫内膜成熟与卵泡发育同步，并允许胚胎着床。胚胎植入中隐含的基因正在被鉴定（例如，整联蛋白）。最后但同样重要的是，正在阐明子宫内膜脱落的机制，尤其是金属蛋白酶和血管生成因子的作用。这些概念将有助于开发新的不孕症治疗方法、设计新的避孕技术，以及更好地耐受性类固醇治疗，尤其是仅含孕激素的药丸。子宫内膜成熟与卵泡发育同步，并允许胚胎着床。胚胎植入中隐含的基因正在被鉴定（例如，整联蛋白）。最后但同样重要的是，正在阐明子宫内膜脱落的机制，尤其是金属蛋白酶和血管生成因子的作用。这些概念将有助于开发新的不孕症治疗方法、设计新的避孕技术，以及更好地耐受性类固醇治疗，尤其是仅含孕激素的药丸。子宫内膜成熟与卵泡发育同步，并允许胚胎着床。胚胎植入中隐含的基因正在被鉴定（例如，整联蛋白）。最后但同样重要的是，正在阐明子宫内膜脱落的机制，尤其是金属蛋白酶和血管生成因子的作用。这些概念将有助于开发新的不孕症治疗方法、设计新的避孕技术，以及更好地耐受性类固醇治疗，尤其是仅含孕激素的药丸。