Impact of three periovulatory progesterone fluctuations in ovulation and tubal suction of released ovum: A new perspective.

Dharwadkar Asha A.; Dharwadkar Anand R.; Chenmarathy Bindu B.

Volume : VI, Issue : VII, July - 2017

Impact of three periovulatory progesterone fluctuations in ovulation and tubal suction of released ovum: A new perspective.

Dharwadkar Asha A. , Dharwadkar Anand R. , Chenmarathy Bindu B.

Abstract :

New perceptive theory concentrates on progesterone [PR] [t/2=30min] respiratory center stimulation causing respiratory alkalosis, low plasma ionic calcium, smooth–muscle relaxation, generalized vasodilatation. Impact of three periovulatory PR fluctuations on ovulation is highlighted. First preovulatory PR spurt fluctuation is due to PR accumulation as intermediary product in estrogen [ER] synthesis during negative feedback effect of 1^st ER peak and is responsible for hypothalamo – hypophyseal vasodilatation producing preovulatory gonadotropins� surge, augments PR synthesis through explosive dominant follicular proliferation. Resultant elevated intrafollicular pressure compressing dilated thecal vessels causes follicular wall ischemia, prevents follicular PR absorption into circulation producing 2^ndPR withdrawal fluctuation .PR withdrawal induced follicular vascular wall contraction augments intrafollicular pressure squeezing antral fluid and ovum out through stigma i.e. weakened follicular wall. It manifests as Mittelschmerz and endometrial spotting. 3^rd postovulatory PR fluctuation due to peritoneal antral fluid PR absorption causes relaxation of already spastically contracted uterus facilitating tubal ovum suction.