Buckett W M, Tan S L
Department of Obstetrics and Gynecology, McGill University Royal Victoria Hospital, Montreal, Quebec, Canada.
Baillieres Clin Obstet Gynaecol. 1998 Dec;12(4):593-606. doi: 10.1016/s0950-3552(98)80054-0.
Luteinizing hormone releasing hormone (LHRH) agonists have been used in conjunction with gonadotrophins, and occasionally with pulsatile LHRH, for ovulation induction in women with clomiphene-citrate-resistant polycystic ovary syndrome (PCOS) and also for superovulation for in vitro fertilization (IVF) and gamete intrafallopian transfer in women with PCOS. In IVF, LHRH agonists given by the 'long protocol' before gonadotrophins are commenced have consistently shown higher pregnancy rates and higher live birth rates. Although the optimal time to commence LHRH agonist is not clearly determined, commencement in the early follicular phase possibly with pre-treatment with the combined oral contraceptive pill would avoid the risk of inadvertent administration during early pregnancy. The role of LHRH agonists in ovulation induction is less clear cut, although there may be some advantages in patients with refractory PCOS. The role of LHRH agonists in ovarian hyperstimulation syndrome and recurrent miscarriage is also discussed.
促黄体生成激素释放激素（LHRH）激动剂已与促性腺激素联合使用，偶尔也与脉冲式LHRH联合使用，用于治疗对枸橼酸氯米芬耐药的多囊卵巢综合征（PCOS）女性的排卵诱导，也用于PCOS女性体外受精（IVF）的超排卵及配子输卵管内移植。在IVF中，在开始使用促性腺激素之前采用“长方案”给予LHRH激动剂，一直显示出较高的妊娠率和较高的活产率。虽然开始使用LHRH激动剂的最佳时间尚未明确确定，但在卵泡早期开始使用，可能预先用复方口服避孕药进行预处理，可避免在早孕期间意外给药的风险。LHRH激动剂在排卵诱导中的作用尚不太明确，尽管对于难治性PCOS患者可能有一些优势。本文还讨论了LHRH激动剂在卵巢过度刺激综合征和复发性流产中的作用。
