Initially, the ovarian failure is compensated by gonadotropin levels starting to rise, in some women from the age of 30 years. During this time there is evidence for a reduced number of gonadotrophin receptors in perimenopausal ovaries and Inhibin production from granulosa cells falls leading to a reduced Inhibin : FSH ratio. Decompensated failure then occurs due to the critical decline in the oocyte pool leading to further rises in follicle stimulating hormone (FSH) (10 to 20-fold); Luteinizing hormone (LH) rises only three fold due to its shorter half-life. Oestrogen levels drop due to a reduction in follicle number and qualitative effect on granulosa cell ageing. There is permanent cessation of progesterone production. Studies have shown that the decline in Inhibin B is progressive and not superior to FSH as a predictor of the FMP . However, the early follicular phase drop is more readily detectable than FSH as an initial predictor of reduced ovarian reserve and menstrual irregularity.
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Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.