The Somatotrophic Axis and the Reproductive Process in Health and Dise

For many years now, our understanding of the somatotrophic and reproduc tive axes has evolved essentially independently, both fields of study reaching a highly advanced, although far from complete, level of under standing. Along the way, however, it became apparent that in some circumstances the reproductive and somatotrophic axes may be inter dependent. Inklings to this effect were at times feeble and at other times more convincing. Among those inklings are the clinical recognition by pediatric endocrinologists of the apparent association between isolated GH deficiency and delayed puberty, as well as of the apparent permissive, pUberty-promoting property of GH. Equally important is a body of experi mental studies establishing the ovary of multiple species as a site of GH reception and action. Arguing against an essential role for GH in the reproductive process is the observation that individuals who have GH resistance of the Laron variety are fertile arid that isolated GH deficiency does not constitute an absolute barrier to the attainment of sexual maturation and fertility. The intraovarian insulin-like growth factor (IGF) hypothesis proposes that IGFs may serve as amplifiers of gonadotropin action. Although the dependence of intraovarian IGFs on systemic GH action has never been unequivocally demonstrated, that leap of faith has often been made. The intraovarian IGF hypothesis serves as the rationale for the adjunctive use of GH in the induction of ovulation.

Arguing against an essential role for GH in the reproductive process is the observation that individuals who have GH resistance of the Laron variety are fertile arid that isolated GH deficiency does not constitute an absolute barrier to the attainment of sexual maturation and fertility.

I. Growth Hormone and Its Receptor: State of the Art.- 1. Growth Hormone: A Current Perspective.- 2. Probing and Designing Growth Hormone-Receptor Interactions.- 3. Human Growth Hormone Binding Proteins: Regulation and Physiological Significance.- 4. Ovarian Prolactin Receptors and Their Placental Ligands.- 5. Regulatory Actions of Testosterone on Pulsatile Growth Hormone Secretion in the Human: Studies Using Deconvolution Analysis.- 6. Growth Hormone and IGF-I as Anabolic Partitioning Hormones.- II. Pubertal, Menstrual, Gestational, and Menopausal Adaptation.- 7. Growth Hormone Secretory Dynamics During Puberty.- 8. Impact of Growth Hormone on the Timing and Progression of Puberty: How Are Growth and Sexual Maturation Linked?.- 9. Role of Growth Hormone in the Promotion of Linear Skeletal Growth.- 10. Growth Hormone Economy in Normally Cycling Women.- 11. Gestational Physiology of the Growth Hormone Gene Family.- 12. Growth Hormone Economy in Menopausal Women: Effects of Age.- 13. Growth Hormone Economy in Hypogonadism: Effects of Sex Steroids.- III. Growth Hormone: The Ovarian Connection.- 14. Ovary as a Site of Growth Hormone Reception and Action.- 15. Ovarian IGF System: Interface with the Gonadotropic and Somatotrophic Axes.- 16. Is the Intraovarian IGF System a Mediator of Growth Hormone Action?.- 17. Evidence for a Role of Growth Hormone-Insulin-Like Growth Factor System in the Polycystic Ovary Syndrome (PCOS).- 18. Evidence Against a Role for the Growth Hormone-Insulin-Like Growth Factor System in the Polycystic Ovary Syndrome.- IV. Potential Utility of Growth Hormone in Clinical Reproductive Medicine.- 19. Diagnosing Growth Hormone Deficiency in Adults.- 20. Growth Hormone Delivery, Dosing, and Pharmacokinetics in Adults.- 21. Role of Growth Hormone Therapy inTurner Syndrome.- 22. Role of Growth Hormone in the Treatment of Postmenopausal Osteoporosis.- V. Potential Utility of Growth Hormone in Ovulation Induction.- 23. Evidence for the Utility of Growth Hormone in the Enhancement of Ovulation.- 24. Evidence Against the Utility of Growth Hormone in the Enhancement of Ovulation.- Author Index.