Duffy · Endocrine reviews 2019 · narrative review · n=?

Ovulation: Parallels With Inflammatory Processes.

Cited 517 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative mechanistic review synthesizing molecular pathways without primary clinical data.

PubMed 30496379 · doi:10.1210/er.2018-00075 · record verified 2026-08-29

What was done

This narrative review synthesized cellular and molecular evidence examining the parallels between inflammatory signaling pathways and the cascade of events triggered by the midcycle luteinizing hormone (LH) surge during follicular rupture and oocyte release.

What was found

The abstract reports no numerical findings. It describes that LH triggers granulosa and theca cells to produce steroids, prostaglandins, chemokines, and cytokines. These mediators activate nonimmune ovarian cells and resident immune cells, recruit additional immune cells, activate proteolytic pathways to degrade the basal lamina and follicular stroma, promote cumulus expansion, remodel the extracellular matrix at the follicular apex, and stimulate angiogenesis, culminating in follicle rupture alongside unique processes such as oocyte maturation.

Why it matters

It outlines the biological framework showing that tissue remodeling and vascular changes during ovulation rely heavily on conserved inflammatory mediators and immune cell recruitment.

Limits

The paper is a qualitative narrative review rather than a systematic review. The abstract provides no quantitative data, effect sizes, or study selection criteria, and the summarized mechanisms rely heavily on preclinical and bench research models.

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