Shaw R W
Clin Obstet Gynaecol. 1976 Dec;3(3):485-503.
The availability of RIA to measure the pituitary gonadotropins and ovarian sex steroids has greatly helped in the development of tests of hypothalamic-pituitary-ovarian function. The use of estimates of basal gonadotrophin and sex steroid hormones together with dynamic tests such as the LH-RH test, oestrogen provocation test, clomiphene tests and exogenous gonadotrophins can now test the integrity and functional capacity of each of the components of the HPO axis. Figure 4 demonstrates how these tests can be used in a logical sequence to investigate patients with a disorder of the HPO axis after having first excluded any other endocrine abnormality. Screening of serum for elevated levels of gonadotrophins, prolactin and progesterone is an important initial step. Interpretation of the oestrogen provocation and clomiphene tests requires a normally functioning pituitary gland and hence the response to an LH-RH test also plays a ket role. The flow chart also demonstrates the points at which specific ovulation induction treatment can be instituted and should be useful in saving patient and doctor investigative time. Using these types of tests it should be possible to reclassify disorders of the HPO axis on the basis of their underlying pathology.
放射免疫分析法（RIA）用于测定垂体促性腺激素和卵巢甾体激素，极大地推动了下丘脑-垂体-卵巢功能检测方法的发展。现在，结合基础促性腺激素和甾体激素的测定结果以及诸如促黄体生成素释放激素（LH-RH）试验、雌激素激发试验、克罗米芬试验和外源性促性腺激素等动态试验，能够检测下丘脑-垂体-卵巢（HPO）轴各组成部分的完整性和功能。图4展示了在首先排除任何其他内分泌异常后，如何按逻辑顺序使用这些试验来研究患有HPO轴紊乱的患者。检测血清中促性腺激素、催乳素和孕酮水平升高是重要的初始步骤。雌激素激发试验和克罗米芬试验的解读需要垂体功能正常，因此对LH-RH试验的反应也起着关键作用。流程图还展示了可以开始特定促排卵治疗的时机，这对于节省患者和医生的检查时间应该是有用的。使用这些类型的试验，应该能够根据潜在病理对HPO轴紊乱进行重新分类。
