de Moura M D, Ferriani R A, de Sá M F
Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Fertil Steril. 1992 Sep;58(3):504-7. doi: 10.1016/s0015-0282(16)55252-2.
To evaluate the effects of clomiphene citrate (CC) on pituitary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) release in hypoestrogenic women and in the same women after treatment with ethinyl estradiol (EE2).
The study was of a prospective nature and was conducted on selected patients.
Volunteer women were studied in a tertiary care public hospital.
The 10 patients studied were selected on the basis of hypogonadal status (menopause, premature ovarian failure, or gonadal dysgenesis and Turner phenotype) and no hormonal treatment.
Gonadotropin-releasing hormone (GnRH) was continually infused at the dose of 0.2 micrograms/min for 4 hours before and after the use of CC and/or EE2.
The study was performed with the objective of determining the effect of estrogen (E) levels on the action of CC on in vivo gonadotropin release.
In the presence of hypoestrogenic conditions, CC had no pituitary action. However, after EE2 treatment CC promoted greater FSH release and a significant inhibition of LH release from the pituitary.
Clomiphene citrate needs a basal E level to be able to act on the pituitary. In normoestrogenic states and under GnRH stimulation, CC preferentially promotes FSH release while presenting a predominantly inhibitory effect on LH release.
评估枸橼酸氯米芬（CC）对雌激素水平低下女性以及这些女性经乙炔雌二醇（EE2）治疗后垂体促黄体生成素（LH）和促卵泡生成素（FSH）释放的影响。
本研究为前瞻性研究，针对选定患者开展。
在一家三级护理公立医院对志愿女性进行研究。
所研究的10名患者基于性腺功能减退状态（绝经、卵巢早衰、性腺发育不全及特纳表型）且未接受激素治疗而入选。
在使用CC和/或EE2之前及之后，以0.2微克/分钟的剂量持续输注促性腺激素释放激素（GnRH）4小时。
本研究旨在确定雌激素（E）水平对CC体内促性腺激素释放作用的影响。
在雌激素水平低下的情况下，CC对垂体无作用。然而，经EE2治疗后，CC促进了更多FSH释放，并显著抑制了垂体LH释放。
枸橼酸氯米芬需要基础E水平才能作用于垂体。在雌激素正常状态下且在GnRH刺激下，CC优先促进FSH释放，同时对LH释放呈现主要抑制作用。
