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多囊卵巢综合征:即使对于既往超反应患者,低剂量促卵泡生成素给药也是一种安全的刺激方案。

Polycystic ovary syndrome: low-dose follicle stimulating hormone administration is a safe stimulation regimen even in previous hyper-responsive patients.

作者信息

Dale P O, Tanbo T, Haug E, Abyholm T

机构信息

Department of Gynaecology and Obstetrics, National Hospital, University of Oslo, Norway.

出版信息

Hum Reprod. 1992 Sep;7(8):1085-9. doi: 10.1093/oxfordjournals.humrep.a137797.

Abstract

We studied 23 women with polycystic ovarian syndrome (PCOS), resistant to clomiphene citrate, who had a previous history of multifollicular ovarian development on gonadotrophin stimulation. Each woman had one cycle of gonadotrophin-stimulating hormone agonist/human menopausal gonadotrophin (GnRHa/HMG) stimulation and then one cycle of low-dose follicle stimulating hormone (FSH) stimulation. All GnRHa/HMG cycles were multifollicular. On the low-dose FSH protocol, 10 cycles were unifollicular, while two to three follicles were observed in nine cycles, and four cycles were multifollicular. The ovarian hyperstimulation syndrome ensued in one of the FSH cycles versus 13 of the GnRHa/HMG cycles. Despite decreasing luteinizing hormone (LH) levels and increasing FSH levels, androgen levels increased during stimulation on both protocols. There was one pregnancy in the GnRHa/HMG cycles versus six pregnancies following the FSH cycles. In conclusion, low-dose FSH administration seems a safe stimulation regimen with a satisfactory conception rate even in PCOS women with a previous record of multifollicular ovarian development.

摘要

我们研究了23名患有多囊卵巢综合征(PCOS)且对枸橼酸氯米芬耐药的女性,她们既往在促性腺激素刺激下有多个卵泡发育的病史。每位女性接受了一个周期的促性腺激素释放激素激动剂/人绝经期促性腺激素(GnRHa/HMG)刺激,然后进行一个周期的低剂量促卵泡生成素(FSH)刺激。所有GnRHa/HMG周期均为多卵泡发育。在低剂量FSH方案中,10个周期为单卵泡发育,9个周期观察到2至3个卵泡,4个周期为多卵泡发育。FSH周期中有1例发生卵巢过度刺激综合征,而GnRHa/HMG周期中有13例发生。尽管在两种方案刺激过程中促黄体生成素(LH)水平降低、FSH水平升高,但雄激素水平均升高。GnRHa/HMG周期中有1例妊娠,而FSH周期后有6例妊娠。总之,即使对于既往有多个卵泡发育记录的PCOS女性,低剂量FSH给药似乎也是一种安全的刺激方案,且受孕率令人满意。

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