Malcolm Christine E, Cumming David C
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Obstet Gynecol. 2003 Aug;102(2):317-8. doi: 10.1016/s0029-7844(03)00527-1.
To determine whether anovulation exists in normally menstruating women.
In a database of 550 consecutive couples seeking pregnancy, results of the midluteal serum progesterone level analysis planned for 7 days before the onset of the next menses were examined in women with predictable cycles shorter than 35 days.
Of the 550 couples seeking pregnancy, 410 of the female partners (74.5%) were eumenorrheic. Fifteen of these women (3.7%) had apparently anovulatory cycles with a progesterone lower than the normal ovulatory value of 15 nmol/L. Further examination showed that four of the 15 women (26.7%) had an isolated prolonged cycle, whereas an additional four (26.7%) failed to have their sample taken at an appropriate time. One (6.7%) had a low progesterone level that was normal in the subsequent cycle. Two patients (13.3%) were older than 40, both having elevated early follicular follicle-stimulating hormone levels. One patient (6.7%) conceived in the following menstrual cycle without further evaluation. The three remaining women (20%) showed consistently apparently anovulatory cycles. However, the levels were exclusively above the follicular range.
Our findings cast doubt on the concept of anovulatory cycles in eumenorrheic women and suggest that further examination of the lower level of ovulatory progesterone may indeed be necessary.
确定月经正常的女性是否存在无排卵情况。
在一个包含550对连续寻求妊娠的夫妇的数据库中，对月经周期可预测且短于35天的女性，检查计划在下一次月经来潮前7天进行的黄体中期血清孕酮水平分析结果。
在550对寻求妊娠的夫妇中，410名女性伴侣（74.5%）月经正常。其中15名女性（3.7%）的周期明显无排卵，孕酮水平低于正常排卵值15 nmol/L。进一步检查显示，15名女性中有4名（26.7%）有孤立的月经周期延长情况，另有4名（26.7%）未能在合适时间采集样本。1名女性（6.7%）孕酮水平较低，但在随后的周期中正常。2名患者（13.3%）年龄超过40岁，她们的卵泡期早期促卵泡生成素水平均升高。1名患者（6.7%）在下一个月经周期怀孕，未作进一步评估。其余3名女性（20%）的周期一直明显无排卵。然而，这些水平均仅高于卵泡期范围。
我们的研究结果对月经正常女性无排卵周期的概念提出了质疑，并表明确实有必要对较低水平的排卵孕酮进行进一步检查。
