Timmerman-van Kessel E C, Cikot R J, Dargel-Donkers E J, Zwertbroek W, van Dop P A, Schoot D C
Catharina Hospital, Eindhoven, The Netherlands.
Fertil Steril. 2000 Jun;73(6):1145-8. doi: 10.1016/s0015-0282(00)00535-5.
To compare the endocrine changes in the follicular phase in infertile patients with polycystic ovary syndrome (PCOS) treated with either pulsatile IV GnRH after GnRH-agonist (GnRH-a) down-regulation or clomiphene citrate (CC).
Subgroup analysis within a randomized, controlled, multicenter study.
Women referred to the Infertility Clinic, Catharina Hospital Eindhoven, The Netherlands.
PATIENT(S): Twenty-eight infertile patients with PCOS. INTERVENTIONs): Patients were randomly assigned to pulsatile IV GnRH (10-20 microgram/90 min) after GnRH-a down-regulation or CC (50-150 mg; cycle days 3-7). Patients were monitored on alternate days with ovarian sonography and serum concentrations of E(2), LH, and FSH. Serum P and sonography confirmed ovulation.
MAIN OUTCOME MEASURE(S): Serum concentrations of E(2), LH, and FSH were assessed before treatment was started and after each ovarian sonography.
RESULT(S): In ovulatory cycles, no statistically significant differences were observed during the follicular phase comparing serum concentrations of E(2), LH, and FSH between the treatments. However, a significant increase in LH occurred in the GnRH group.
CONCLUSION(S): No significant endocrine differences were observed between GnRH and CC treatment. However, there was a significant increase in the serum LH concentration during the follicular phase in the GnRH group. Increments of LH in the GnRH group may be due to recovery of endogenous LH secretion.
比较多囊卵巢综合征（PCOS）不孕患者在GnRH激动剂（GnRH-a）降调节后接受脉冲式静脉注射GnRH治疗或克罗米芬（CC）治疗时卵泡期的内分泌变化。
一项随机对照多中心研究中的亚组分析。
荷兰埃因霍温卡塔琳娜医院不孕门诊。
28例PCOS不孕患者。
患者被随机分配至GnRH-a降调节后接受脉冲式静脉注射GnRH（10 - 20微克/90分钟）或CC（50 - 150毫克；月经周期第3 - 7天）治疗。隔天通过卵巢超声检查以及检测血清E(2)、LH和FSH浓度对患者进行监测。血清P及超声检查确认排卵情况。
在开始治疗前以及每次卵巢超声检查后评估血清E(2)、LH和FSH浓度。
在排卵周期中，卵泡期比较两种治疗方法的血清E(2)、LH和FSH浓度时，未观察到统计学上的显著差异。然而，GnRH组的LH出现显著升高。
GnRH治疗与CC治疗之间未观察到显著的内分泌差异。然而，GnRH组在卵泡期血清LH浓度显著升高。GnRH组LH的升高可能是由于内源性LH分泌的恢复。
