Introduction: Current health literature suggests that there has been a decline in the age of pubertal onset and that pubertal onset/duration of puberty may, besides weight status, be influenced by socioeconomic context. Objective: The goal of this study was to determine whether pubertal onset/ duration and puberty-triggering hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) vary according to socioeconomic status (SES). Moreover, we aimed to propose cutoff values of serum LH and FSH for predicting gonadarche in boys. Methods: 2,657 apparently healthy children and adolescents between 5.5 and 18 years from the area of Leipzig were recruited from the LIFE Child study. Age at pubertal onset/end of puberty was given in 738/573 children, respectively. Anthropometric parameters of puberty, blood measurements of LH and FSH, and questionnaires assessing SES were evaluated. Results: Lower SES was associated with earlier thelarche and longer duration of puberty in overweight/obese girls, whereas age of menarche was not affected. In boys with low SES, a trend versus earlier puberty onset can be seen. Lower SES was significantly associated with boys’ age at mutation. No significant differences in boys’ and girls’ serum levels of LH and FSH during puberty according to SES were observed. Serum LH levels of 0.56 IU/L and serum FSH levels of 1.74 IU/L showed the best prediction of gonadarche in boys. Conclusion: Puberty onset/duration and boys’ age at mutation is affected by SES. The proposed cutoff levels for serum LH and FSH could provide a serological tool to determine gonadarche in boys

In sheep, large ovarian antral follicles grow in waves with a periodicity of every 4 to 5 days; each wave is initiated by a peak in serum concentrations of follicle stimulating hormone (FSH). In the present thesis, follicular data and hormone estimations acquired from daily ultrasonography and blood samples, respectively, were used to study mechanisms regulating the number of follicular waves per estrous cycle. Using additional approaches such as implants releasing estradiol-17â and or progesterone, immunization against gonadotropin releasing hormone (GnRH), and injections of GnRH, the role of pulsed luteinizing hormone (LH) secretion and FSH peaks in follicular wave emergence and growth and the dependency of FSH peaks on pulsed GnRH secretion, were studied in sheep. The viability of aged follicles was also addressed.<p> The results of the present studies showed that ewes with three or four waves per cycle had cycles of the same length. The inter-wave interval was longer for the first and the last or ovulatory wave of the cycle in three compared to four wave cycles. The length of the lifespan and regression phase of the largest follicle of a wave declined across the cycle as FSH peak concentration and amplitude decreased. The maximum follicular diameter of the largest follicle growing in the first wave and the last or ovulatory wave of the cycle was greater compared to other waves of the cycle. Treatment of anestrous ewes with estradiol releasing implants alone completely abolished pulsed LH secretion and suppressed follicular wave development; however, FSH secretion was only minimally affected and the pool of small follicles was not affected. When pulsed secretion of LH was restored by frequent injections of GnRH, follicular waves were re-established. Treatment of anestrous ewes with implants releasing estradiol and progesterone, decreased FSH peak amplitude and abolished LH pulses and follicular waves; the size of the pool of small follicles increased. Immunization against GnRH in anestrous ewes abolished pulsatile LH secretion and suppressed follicular wave emergence; however, FSH peaks continued to occur for several weeks. In cyclic ewes, creating an LH pulse frequency typical of the follicular phase, during the luteal phase of the cycle by giving GnRH, increased maximum diameter of the largest follicle in a wave and serum concentrations of estradiol and progesterone. The enhanced growth of follicles in a wave blocked the next expected FSH peak and its associated follicular wave. Decreasing LH pulse frequencies lower than the minimal frequency seen in the luteal phase, by implants releasing progesterone, did not affect the growth of follicular waves.<p> It was previously demonstrated that treatment of non-prolific WWF ewes with Prostaglandin F2á (PGF2á) and medroxy progesterone acetate (MPA) increased the ovulation rate by adding ovulations from the penultimate wave in addition to the final wave of the cycle; however, fertility was not improved. In the last study of my thesis, we collected follicles, with an extended lifespan, from the penultimate wave of the cycle in ewes given the PGF2á and MPA treatment. We compared their quality with follicles from the final wave of the cycle by looking at the expression of markers of follicular development. The results showed that theca cells of follicles from the final wave had significantly higher mRNA expression for vascular endothelial growth factor (VEGF) compared to follicles from the penultimate wave. Granulosa cells of follicles from the final wave had significantly higher mRNA expression for connexion 43 (Cx43) compared to follicles from the penultimate wave. Protein expression for Cx43, proliferating cell nuclear antigen (PCNA) and Factor VIII was greater in follicles from the final compared to the penultimate wave.<p> We concluded from the present studies that: 1) the mechanism that makes a three wave or four wave cycle is unclear; 2) some level of pulsatile LH secretion is required for an FSH peak to trigger emergence of follicular waves in anestrous ewes; 3) progesterone enhances the inhibitory effects of estradiol on FSH secretion in anestrous ewes, suppressing specifically FSH peak amplitude; 4) an endogenous rhythm may exist that drives the peaks in FSH secretion independent of secretory products from the follicles growing in a wave and pulsed GnRH secretion; 5) follicular waves in ewes, when exposed to an LH pulse frequency similar to the follicular phase, during the luteal phase of the cycle, when serum progesterone concentrations are high, can grow and function like ovulatory follicles growing in the follicular phase of the cycle; 6) expression of some markers of vascularization/ angiogenesis, gap-junctional communication and cell proliferation, appeared to be decreased in follicles from the penultimate compared to the final wave of an estrous cycle, when the lifespan of follicles from the penultimate wave was extended such that they were present in the ovary with follicles from the final wave of the cycle.

Treatment success in IVF-ICSI is mainly limited by female age, but differences in ovarian reserve (OR; the remaining pool of oocytes and their quality) between individuals modify treatment prerequisites among women of similar age. OR may be assessed by OR tests (ORTs). The main aims of this work were to study menstrual cycle length (MCL), basal levels of circulating gonadotrophins, antral follicle count (AFC) and serum Anti-Müllerian hormone (AMH) levels and their associations with and prognostic capacities regarding IVF-ICSI outcome in large cohorts of unselected women. Age-adjusted MCL was positively and linearly associated with pregnancy rates (PRs), live-birth rates (LBRs) and ovarian response to controlled ovarian hyperstimulation. An MCL of &gt;34 days almost doubled the LBR compared with an MCL of &lt;26 days. The grouped variable ‘combined FSH and LH levels’ was superior to both individual gonadotrophin levels and the LH:FSH ratio. The highest mean PR was seen in connection with a combination of FSH &lt;6.7 U/l with LH &gt;4.9 U/l; PRs were lowest when FSH-LH levels were opposite to this (high-low) and intermediate when FSH-LH levels were low-low or high-high. Associations with LBR and ovarian response were similar as those for PR. AFCs and serum AMH levels were positively and log-linearly associated with PR, LBR and ovarian response. Success rates levelled out above AFC 30 or AMH 5 ng/ml. Treatment outcome was superior among women with polycystic ovaries. Among the studied ORTs, logAFC and logAMH concentration correlated most strongly. After multivariate testing, entering all studied ORTs, AMH and female age remained independently associated with LBR. AMH + AFC + age predicted both poor and excessive ovarian responses with high accuracy. Adjusting for age and oocyte yield, all ORTs remained significant for LBR, implying that ORTs also capture information on oocyte quality. In conclusion, measures of OR are strongly associated with PR, LBR and ovarian response in a log-linear fashion, and partly reflect oocyte quality. The OR spectrum is continuous, from small ‘oligofollicular’ ovaries (the low extreme) to polycystic ovaries (the high extreme). Among the studied ORTs, AMH together with age provide the most powerful basal estimate for IVF/ICSI outcome.

In sheep, large ovarian antral follicles grow in waves with a periodicity of every 4 to 5 days; each wave is initiated by a peak in serum concentrations of follicle stimulating hormone (FSH). In the present thesis, follicular data and hormone estimations acquired from daily ultrasonography and blood samples, respectively, were used to study mechanisms regulating the number of follicular waves per estrous cycle. Using additional approaches such as implants releasing estradiol-17â and or progesterone, immunization against gonadotropin releasing hormone (GnRH), and injections of GnRH, the role of pulsed luteinizing hormone (LH) secretion and FSH peaks in follicular wave emergence and growth and the dependency of FSH peaks on pulsed GnRH secretion, were studied in sheep. The viability of aged follicles was also addressed.<p> The results of the present studies showed that ewes with three or four waves per cycle had cycles of the same length. The inter-wave interval was longer for the first and the last or ovulatory wave of the cycle in three compared to four wave cycles. The length of the lifespan and regression phase of the largest follicle of a wave declined across the cycle as FSH peak concentration and amplitude decreased. The maximum follicular diameter of the largest follicle growing in the first wave and the last or ovulatory wave of the cycle was greater compared to other waves of the cycle. Treatment of anestrous ewes with estradiol releasing implants alone completely abolished pulsed LH secretion and suppressed follicular wave development; however, FSH secretion was only minimally affected and the pool of small follicles was not affected. When pulsed secretion of LH was restored by frequent injections of GnRH, follicular waves were re-established. Treatment of anestrous ewes with implants releasing estradiol and progesterone, decreased FSH peak amplitude and abolished LH pulses and follicular waves; the size of the pool of small follicles increased. Immunization against GnRH in anestrous ewes abolished pulsatile LH secretion and suppressed follicular wave emergence; however, FSH peaks continued to occur for several weeks. In cyclic ewes, creating an LH pulse frequency typical of the follicular phase, during the luteal phase of the cycle by giving GnRH, increased maximum diameter of the largest follicle in a wave and serum concentrations of estradiol and progesterone. The enhanced growth of follicles in a wave blocked the next expected FSH peak and its associated follicular wave. Decreasing LH pulse frequencies lower than the minimal frequency seen in the luteal phase, by implants releasing progesterone, did not affect the growth of follicular waves.<p> It was previously demonstrated that treatment of non-prolific WWF ewes with Prostaglandin F2á (PGF2á) and medroxy progesterone acetate (MPA) increased the ovulation rate by adding ovulations from the penultimate wave in addition to the final wave of the cycle; however, fertility was not improved. In the last study of my thesis, we collected follicles, with an extended lifespan, from the penultimate wave of the cycle in ewes given the PGF2á and MPA treatment. We compared their quality with follicles from the final wave of the cycle by looking at the expression of markers of follicular development. The results showed that theca cells of follicles from the final wave had significantly higher mRNA expression for vascular endothelial growth factor (VEGF) compared to follicles from the penultimate wave. Granulosa cells of follicles from the final wave had significantly higher mRNA expression for connexion 43 (Cx43) compared to follicles from the penultimate wave. Protein expression for Cx43, proliferating cell nuclear antigen (PCNA) and Factor VIII was greater in follicles from the final compared to the penultimate wave.<p> We concluded from the present studies that: 1) the mechanism that makes a three wave or four wave cycle is unclear; 2) some level of pulsatile LH secretion is required for an FSH peak to trigger emergence of follicular waves in anestrous ewes; 3) progesterone enhances the inhibitory effects of estradiol on FSH secretion in anestrous ewes, suppressing specifically FSH peak amplitude; 4) an endogenous rhythm may exist that drives the peaks in FSH secretion independent of secretory products from the follicles growing in a wave and pulsed GnRH secretion; 5) follicular waves in ewes, when exposed to an LH pulse frequency similar to the follicular phase, during the luteal phase of the cycle, when serum progesterone concentrations are high, can grow and function like ovulatory follicles growing in the follicular phase of the cycle; 6) expression of some markers of vascularization/ angiogenesis, gap-junctional communication and cell proliferation, appeared to be decreased in follicles from the penultimate compared to the final wave of an estrous cycle, when the lifespan of follicles from the penultimate wave was extended such that they were present in the ovary with follicles from the final wave of the cycle.

Proteins, participating in a myriad of biological function, are at the core of all cellular activities occurring within living organisms. Therapeutic proteins, hence constitute a major part of the pharmaceutical industry. The glycoprotein hormones follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH) and human chorionic gonadotropin (CG) regulate various reproductive and metabolic functions in humans and hence have high therapeutic potentials. The increasing demand of recombinant proteins for therapeutic uses drives the development of better expression systems. The methylotrophic yeast Pichia pastoris, has been termed as an industrial workhorse for heterologous protein expression. However, the N-glycosylation in yeast is of the high mannose type, resulting in a reduced serum half-life of the recombinant proteins. In the current work, we have re-engineered the Pichia N-glycosylation pathway to mimic the human type of N-glycosylation. Towards this end, we abolished the yeast native N-glycosylation and introduced enzymes from various eukaryotic sources into the system. These modifications resulted in the conversion of the yeast Man9-20GlcNAc2 glycan structure to a more human like GlcNAc2Man3GlcNAc2 form on over 70 % of the heterologous expressed proteins. In order to demonstrate the application of these strains as efficient protein expression hosts, the glycoengineerd Pichia was used for large scale expression of the glycoprotein hormones, hCG and FSH. The purified recombinant hormones were found to have binding affinities and structure similar to that of the natural hormones. These recombinant hormones were also able to elicit over two fold responses in animal models compared to buffer controls and the activity was comparable to the natural counterparts. Thus, we report the generation of a glycoengineered Pichia pastoris, which can be considered as a serious contender for the expression of glycosylated proteins of therapeutic importance.