Mulders Annemarie G M G J, Eijkemans Marinus J C, Imani Babak, Fauser Bart C J M
Department of Obstetrics and Gynecology, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Reprod Biomed Online. 2003 Sep;7(2):170-8. doi: 10.1016/s1472-6483(10)61747-6.
This follow-up study evaluated whether initial screening characteristics predict treatment outcome of gonadotrophin induction of ovulation. One hundred and fifty-four women with normogonadotrophic anovulatory infertility for whom clomiphene citrate induction of ovulation was unsuccessful were included in the present study. Daily FSH injections were initiated on day 3-5 after spontaneous or progestagen-induced withdrawal bleeding. In most patients, a dose finding low-dose step-up regimen was applied during the first treatment cycle in order to identify the individual FSH response dose. In all subsequent cycles, a step-down protocol was applied. Initial serum concentrations of LH, testosterone and androstenedione were significant predictors for the probability of multi-follicular development. FSH treatment resulted in a total of 67 (44%) ongoing pregnancies. Comparing those women who did, versus those who did not, achieve an ongoing pregnancy in a multivariate Cox regression analysis, initial serum insulin-like growth factor-I (IGF-I), testosterone and women's age entered into the final model (AUC = 0.67). The individual treatment outcome following gonadotrophin induction of ovulation may be predicted by initial screening characteristics.
这项随访研究评估了初始筛查特征是否能预测促性腺激素诱导排卵的治疗结果。本研究纳入了154名患有正常促性腺激素性无排卵不孕症且枸橼酸氯米芬诱导排卵失败的女性。在自然或孕激素诱导的撤药性出血后的第3 - 5天开始每日注射促卵泡生成素（FSH）。在大多数患者中，在第一个治疗周期采用剂量探索性低剂量递增方案，以确定个体对FSH的反应剂量。在所有后续周期中，采用递减方案。促黄体生成素（LH）、睾酮和雄烯二酮的初始血清浓度是多卵泡发育概率的显著预测指标。FSH治疗共导致67例（44%）持续妊娠。在多变量Cox回归分析中，比较那些成功与未成功实现持续妊娠的女性，初始血清胰岛素样生长因子-I（IGF-I）、睾酮和女性年龄进入最终模型（曲线下面积 = 0.67）。促性腺激素诱导排卵后的个体治疗结果可通过初始筛查特征进行预测。
