de Ziegler D, Brioschi P A, Benchaa C, Campana A, Ditesheim P J, Fanchin R, Bulletti C
Reproductive Endocrinology and Infertility, Hôpital de Nyon, Switzerland.
Fertil Steril. 1999 Jul;72(1):77-82. doi: 10.1016/s0015-0282(99)00155-7.
To synchronize the intercycle FSH elevation with exogenous E2 for programming ovulation in the menstrual cycle.
Open single-arm study.
Teaching hospital.
PATIENT(S): Twenty-six patients with infertility whose menstrual cycles normally lasted 25-35 days and who underwent our routine programming method for postcoital tests and ovulation evaluations.
INTERVENTION(S): Participants received estradiol valerate (2 mg) twice a day from day 25 of the previous cycle until 1-15 days after the onset of menses. Women had ultrasonography on the last day of E2 treatment or on functional day 0 and 13 days later or on functional day 13. Hormones were determined on functional days 0, 3, 9, and 13. The increase in FSH in response to E2 withdrawal was defined as deltaFSH.
MAIN OUTCOME MEASURE(S): LH surge and other ovulatory indices on functional day 13.
RESULT(S): On functional day 13, 73% of the women had an LH surge. Fifteen percent had evidence of previous ovulation with low LH and elevated plasma P levels, and the remaining 12% had low LH levels and no evidence of past or imminent ovulation. Women with evidence of early ovulation were older and had higher FSH signal amplitude.
CONCLUSION(S): It is feasible and practical to program ovulation in the menstrual cycle with exogenous E2. In 73% of women, the true duration of the follicular phase (intercycle FSH elevation to LH surge interval) remained constant (13 days). Hence, common fluctuations in menstrual cycle length mainly result from variations in the timing of the intercycle FSH elevation. Although rare, truly short follicular phases also exist (15%). This simple and practical system for programming natural ovulation offers new possibilities for using the menstrual cycle in assisted reproductive technology, at least in selected individuals.
使月经周期中促卵泡生成素（FSH）的周期间升高与外源性雌二醇（E2）同步，以调控月经周期中的排卵。
开放性单臂研究。
教学医院。
26例不孕患者，其月经周期通常持续25 - 35天，且接受了我们用于性交后试验和排卵评估的常规调控方法。
参与者从前一周期的第25天开始，每天两次服用戊酸雌二醇（2毫克），直至月经来潮后1 - 15天。在E2治疗的最后一天、功能日0、13天后或功能日13进行超声检查。在功能日0、3、9和13测定激素水平。E2撤药后FSH的升高定义为△FSH。
功能日13时的促黄体生成素（LH）峰及其他排卵指标。
在功能日13时，73%的女性出现LH峰。15%的女性有既往排卵的证据，LH水平低且血浆孕酮（P）水平升高，其余12%的女性LH水平低，无既往或即将排卵的证据。有早期排卵证据的女性年龄较大，FSH信号幅度较高。
用外源性E2调控月经周期中的排卵是可行且实用的。在73%的女性中，卵泡期的真正时长（周期间FSH升高至LH峰的间隔）保持恒定（13天）。因此，月经周期长度的常见波动主要源于周期间FSH升高时间的变化。虽然少见，但真正短的卵泡期也存在（15%）。这种简单实用的自然排卵调控系统为辅助生殖技术中月经周期的应用提供了新的可能性，至少在特定个体中如此。
