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Fig. 6 | BMC Cancer

Fig. 6

From: Ovarian hyperstimulation closely associated with resumption of follicular growth after chemotherapy during tamoxifen treatment in premenopausal women with breast cancer: a multicenter retrospective cohort study

Fig. 6

Hypothalamic-pituitary-ovarian axis in group C. a, chemotherapy can damage the ovarian oocyte reserve and subsequently reduce inhibin production from ovarian follicles, decreasing the direct suppression of FSH secretion from the pituitary. By a negative feedback mechanism through the hypothalamic-pituitary axis, low production of estradiol and administration of anti-estrogenic TAM can induce high-level secretion of gonadotropins, concomitant with loss of the direct suppressive effects of inhibin on FSH secretion. b, at the regrowth of follicles after chemotherapy, since negative feedback is inhibited by TAM, the re-activated process of follicular growth can be accelerated by the excessive secretion of gonadotropins under these conditions, explaining the high incidence of OHS following amenorrhea

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