Nakagawa Koji, Takahashi Yuji, Ito Megumu, Horikawa Takashi, Ohgi Shirei, Irahara Minoru, Saito Hidekazu
Division of Reproductive Medicine, Department of Perinatal Medicine and Maternal Care, National Center for Child Health and Development, Okura, Setagaya, Tokyo, Japan.
J Assist Reprod Genet. 2006 Mar;23(3):105-10. doi: 10.1007/s10815-005-9007-z. Epub 2006 May 12.
Intraovarian arterial blood flows before and after follicular rupture in ovulation induced cycles were examined by transvaginal color flow Doppler imaging. The changes observed in the intraovarian arterial resistance before and after ovulation in relation to the regularity of menstruation and several other parameters were analyzed.
In a prospective study, 22 patients undergoing infertility treatment in our center were recruited. Patients were divided into two subgroups, according to their menstrual regularity (regular menstrual group and oligomenorrheal group) and 42 cycles were studied. All patients received the same FSH low-dose stimulation treatment. The relationship between the post and preovulatory arterial pulsatility indexes (PI) was analyzed. Cycles that showed a decrease in their PI after ovulation of 10% or more were considered "profoundly decreased cycles." Cycles from the same patients without ovulatory stimulation (natural cycles) were used as control.
In the regular menstrual group the rate of profoundly decreased cycles during FSH stimulation was 63.2%, which was similar to the rate observed in natural cycles. In the oligomenorrheal group the rate of profoundly decreased cycles during natural cycles was 14.3%, but in FSH ovulation induction cycles this rate was significantly increased (47.6%, p < 0.05). In addition, the pregnancy rate per cycle in the oligomenorrheal group was significantly higher than that in the regular menstrual group (p = 0.03).
Oligomenorrheal patients presented a higher rate in the decrease of their PI values after FSH stimulation, which is essential to achieve pregnancy. This elevated rate of reduction implies that oligomenorrheal patients have increased incidence of disturbance in their ovulatory process when compared to normal cycling patients. Thus, ovulation induction with FSH, in oligomenorrheal patients resulted in a higher pregnancy rate in this group.
通过经阴道彩色多普勒血流成像检查诱导排卵周期中卵泡破裂前后卵巢内动脉血流情况。分析排卵前后卵巢内动脉阻力的变化与月经规律及其他几个参数之间的关系。
在一项前瞻性研究中，招募了本中心22例接受不孕症治疗的患者。根据月经规律将患者分为两个亚组（月经规律组和月经过少组），共研究42个周期。所有患者均接受相同的低剂量促卵泡生成素（FSH）刺激治疗。分析排卵后与排卵前动脉搏动指数（PI）之间的关系。排卵后PI下降10%或更多的周期被视为“显著下降周期”。将同一患者未进行排卵刺激的周期（自然周期）作为对照。
月经规律组在FSH刺激期间显著下降周期的发生率为63.2%，与自然周期中观察到的发生率相似。月经过少组在自然周期中显著下降周期的发生率为14.3%，但在FSH诱导排卵周期中该发生率显著增加（47.6%，p<0.05）。此外，月经过少组每个周期的妊娠率显著高于月经规律组（p=0.03）。
月经过少患者在FSH刺激后PI值下降率较高，这对实现妊娠至关重要。这种升高的下降率意味着与正常月经周期患者相比，月经过少患者排卵过程紊乱的发生率增加。因此，对月经过少患者使用FSH诱导排卵可使该组妊娠率更高。
