Hamilton-Fairley D, Kiddy D, Watson H, Sagle M, Franks S
Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London, UK.
Hum Reprod. 1991 Sep;6(8):1095-9. doi: 10.1093/oxfordjournals.humrep.a137491.
Women with anovulation due to polycystic ovary syndrome are likely to develop multiple follicles during gonadotrophin therapy and therefore have a high risk of multiple pregnancy. We have developed a low-dose regimen for use in these women; 100 women with clomiphene-resistant polycystic ovary syndrome were treated. Ninety-five of the women ovulated at least once, 72% of the 401 cycles induced were ovulatory and the majority (73%) of these were uni-ovulatory. The overall cumulative conception rate was 55% at 6 months with only two multiple pregnancies. The rate of early pregnancy loss was 32%, which is similar to that reported by other groups. The prevalence of complications was low with no cases of severe hyperstimulation and less than 5% of cycles were abandoned because of development of multiple follicles. Analysis of baseline and mid-follicular luteinizing hormone levels showed that a raised baseline and/or mid-follicular luteinizing hormone level was associated with a poor response to treatment, i.e. anovulation, ovulation but no conception, or early pregnancy loss. There were no successful pregnancies in the women whose luteinizing hormone levels were persistently raised during ovulatory cycles. Low-dose gonadotrophin therapy is a safe and effective method of inducing ovulation; it is associated with a high incidence of single follicular development and a very low multiple pregnancy rate.
多囊卵巢综合征所致无排卵的女性在促性腺激素治疗期间可能会发育多个卵泡，因此有多胎妊娠的高风险。我们已研发出一种低剂量方案用于这些女性；对100例克罗米芬抵抗的多囊卵巢综合征女性进行了治疗。其中95例女性至少排卵一次，在诱导的401个周期中，72%为排卵周期，且其中大多数（73%）为单卵泡排卵。6个月时总体累积妊娠率为55%，仅有2例多胎妊娠。早期妊娠丢失率为32%，与其他组报道的相似。并发症发生率较低，无严重卵巢过度刺激综合征病例，因多个卵泡发育而放弃的周期不到5%。对基础和卵泡中期促黄体生成素水平的分析表明，基础和/或卵泡中期促黄体生成素水平升高与治疗反应不佳相关，即无排卵、排卵但未受孕或早期妊娠丢失。在排卵周期中促黄体生成素水平持续升高的女性中未成功妊娠。低剂量促性腺激素治疗是一种安全有效的诱导排卵方法；它与单卵泡发育的高发生率和极低的多胎妊娠率相关。
