A comparison of the neuroendocrine mechanisms underlying the initiation of the preovulatory LH surge in the human, Old World monkey and rodent.

As recognized for decades, the role of the rodent hypothalamus in timing the LH surge is deterministic and mediated by a GnRH discharge that is generated by an obligatory interaction in the preoptic area (POA) between a threshold level of estradiol and a circadian neural signal: a view consistent with contemporary kisspeptinocentric models of the estrous cycle. In higher primates, generation of the LH surge is emancipated from control by the POA. Woman represents the exemplar of the system in higher primates, as the LH surge appears to unfold in the absence of a midcycle GnRH discharge being generated instead by facilitatory interaction between a pulsatile GnRH input to the pituitary and an action of ovarian estradiol. The neurobiology of GnRH pulse generation is only beginning to emerge but from a translational perspective this aspect of hypothalamic function is critical for understanding the human menstrual cycle and how it may be perturbed.