Balen Adam
Department of Reproductive Medicine, The General Infirmary, Leeds LS2 9NS, UK.
Hum Fertil (Camb). 2003 May;6 Suppl 1:S42-51. doi: 10.1080/1464770312331369263.
The aim of ovulation induction therapy should be, wherever possible, to correct the underlying disturbance and achieve safe, repeated unifollicular ovulation to achieve the live birth of singleton babies. This article outlines the main causes of anovulatory infertility but deals mostly with the management of anovulatory polycystic ovary syndrome (PCOS), which is the most common problem to confront specialists in reproductive medicine. PCOS is associated with insulin resistance, particularly in those who are overweight. Thus, strategies to achieve weight loss and improve insulin sensitivity, including the use of drugs such as metformin, enhance reproductive function. Therapies to induce ovulation involve first the use of the anti-oestrogen clomiphene citrate. For those who fail to ovulate in response to clomiphene citrate, the principal options include parenteral gonadotrophin therapy or laparoscopic ovarian diathermy.
排卵诱导治疗的目标应尽可能纠正潜在的紊乱情况，实现安全、反复的单卵泡排卵，以实现单胎活产。本文概述了无排卵性不孕症的主要原因，但主要讨论无排卵性多囊卵巢综合征（PCOS）的管理，这是生殖医学专家面临的最常见问题。PCOS与胰岛素抵抗有关，尤其是超重者。因此，包括使用二甲双胍等药物在内的实现体重减轻和改善胰岛素敏感性的策略可增强生殖功能。诱导排卵的治疗首先使用抗雌激素克罗米芬柠檬酸盐。对于对克罗米芬柠檬酸盐无排卵反应的患者，主要选择包括胃肠外促性腺激素治疗或腹腔镜卵巢透热疗法。
