Role of growth hormone in ovarian physiology and onset of puberty

OBJECTIVE: To review the role of growth hormone (GH) in the timing of puberty and to summarize the interactions between the somatotrophic and reproductive axes. The use of recombinant GH in patients with GH deficiency is outlined. METHODS: A MEDLINE search was performed of English language manuscripts dealing with the role or use of GH in puberty and reproduction. RESULTS: Growth hormone appears to augment the rate of sexual maturation once a pubertal pattern of gonadotropin secretion is established. Growth hormone may modulate gonadal steroid production by increasing hepatic insulin-like growth factor-I production or by acting directly on GH receptors, localized recently in the granulosa cells and corpus luteum in the human ovary. Patients with isolated GH deficiency exhibit short stature, truncal adiposity, and delayed puberty. However, patients with isolated GH deficiency ultimately undergo spontaneous puberty, and women with GH receptor defects are fertile, suggesting that GH most likely acts as a co-gonadotropin to augment the actions of FSH and LH on estradiol and progesterone production. CONCLUSIONS: Growth hormone appears to increase the rate of sexual maturation once a pubertal pattern of pituitary gonadotropin secretion is established. The ovary is a site of GH reception and action, where it can potentiate steroidogenesis and gametogenesis either directly or through endocrine actions. Continued basic and clinical research is needed to characterize further the role of GH in reproductive physiology. Copyright (C) 1997 by the Society for Gynecologic Investigation.