Ovulation as an inflammatory reaction: A hypothesis

Abstract

The objective of this paper is to develop a 'working model' which integrates the physical and chemical events that are presently known to take place in a mature ovarian follicle during ovulation. The model is based on the hypothesis that an ovulatory surge of gonadotropin induces an inflammatory reaction in mature follicles and that it is this inflammatory condition which brings about the actual rupture of the ovarian surface. The comparison of ovulation to an inflammatory process is not a farfetched idea. The literature reveals substantial evidence that ovulatory follicles have numerous features similar to those of inflamed tissues. More importantly, by describing ovulation as an inflammatory reaction, it is possible to formulate a model which incorporates most of the current data on the biochemical changes which take place during ovulation. Of particular interest is the central role which this hypothesis gives to prostaglandins as mediators of the inflammatory process. In addition, the hypothetical model establishes a relationship between prostaglandins and ovarian proteolytic activity. In developing the hypothesis, the first section of this paper will outline the basic features of an inflammatory process. The main portion of the review concentrates on specific similarities between the metabolic events that are known to occur in both inflammation and ovulation. Toward the end, the report considers antiinflammatory agents as potential regulators of ovulation. The final pages synthesize the data into a 'working model' of ovulation as an inflammatory reaction.