Filicori Marco, Cognigni Graciela Estela, Taraborrelli Stefania, Parmegiani Lodovico, Bernardi Silvia, Ciampaglia Walter
Reproductive Endocrinology Center, Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.
Fertil Steril. 2002 Aug;78(2):414-6. doi: 10.1016/s0015-0282(02)03243-0.
To prove that several days of low-dose hCG alone can be used to stimulate folliculogenesis, complete FSH-initiated follicle/oocyte maturation, and achieve pregnancy in assisted reproduction technology.
Case report.
Reproductive endocrinology center at an academic institution.
PATIENT(S): A 35-year-old female patient and her partner with male-related infertility.
INTERVENTION(S): After an 8-day priming with hMG (225 IU/d), we administered low-dose hCG (200 IU/d) alone for 5 days in one GnRH-agonist suppressed patient until proper follicle development was obtained and intracytoplasmic sperm injection was performed.
MAIN OUTCOME MEASURE(S): Daily serum levels of LH, FSH, hCG, E(2), P, and T; measurements of follicle number and size; oocytes retrieved and fertilized; pregnancy.
RESULT(S): Although FSH levels rapidly declined after hMG discontinuation, E(2) and large follicles increased during hCG-only administration. Several good quality oocytes were retrieved and fertilized by intracytoplasmic sperm injection; three embryos were transferred and a twin pregnancy ensued.
CONCLUSION(S): Replacement of FSH with low-dose hCG for several days in the late ovulation induction stages of assisted reproduction technology resulted in: [1] continued growth of large ovarian follicles and E(2); [2] an optimal preovulatory follicle pattern consisting of many large and few medium and small follicles; and [3] reproductively competent oocytes and pregnancy.
证明在辅助生殖技术中，单独使用数天低剂量人绒毛膜促性腺激素（hCG）可用于刺激卵泡生成，完成由促卵泡生成素（FSH）启动的卵泡/卵母细胞成熟，并实现妊娠。
病例报告。
一所学术机构的生殖内分泌中心。
一名35岁女性患者及其患有男性相关不育症的伴侣。
在一名使用促性腺激素释放激素激动剂抑制的患者中，先用hMG（225国际单位/天）启动8天，然后单独给予低剂量hCG（200国际单位/天）5天，直至获得适当的卵泡发育并进行卵胞浆内单精子注射。
每日血清促黄体生成素（LH）、促卵泡生成素（FSH）、hCG、雌二醇（E₂）、孕酮（P）和睾酮（T）水平；卵泡数量和大小的测量；获取并受精的卵母细胞；妊娠情况。
尽管停用hMG后FSH水平迅速下降，但在仅给予hCG期间，E₂和大卵泡数量增加。通过卵胞浆内单精子注射获取了几个优质卵母细胞并使其受精；移植了3个胚胎，随后发生双胎妊娠。
在辅助生殖技术的排卵诱导后期，用低剂量hCG替代FSH数天可导致：[1] 大的卵巢卵泡和E₂持续生长；[2] 形成由许多大卵泡以及少量中、小卵泡组成的最佳排卵前卵泡模式；[3] 具有生殖能力的卵母细胞并实现妊娠。
