de Koning C H, McDonnell J, Themmen A P N, de Jong F H, Homburg R, Lambalk C B
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Hum Reprod. 2008 Jun;23(6):1416-23. doi: 10.1093/humrep/den092. Epub 2008 Mar 28.
Elevated early follicular phase (EFP) FSH is frequently observed in subfertile patients. In these women, temporary normalization of FSH concentrations is known to occur. We studied the complete endocrine cycle profile of subfertile young women with elevated basal FSH compared with controls. METHODS Daily bloodsampling and ultrasound monitoring in the follicular phase was performed in 22 patients with elevated basal FSH levels (identified in screening) and in 16 controls during one menstrual cycle and for 5 days of the next cycle.
Eleven patients showed elevated basal FSH levels in the study cycle ('High, High'; H,H group) whereas 11 had normalized basal FSH levels ('High, Low'; H,L group). Anti-Müllerian hormone (AMH) was lower in both groups. In the H,H group, FSH was higher in all phases of the cycle and both inhibin A and B were lower during the EFP. In the H,L group, FSH was also higher than in controls in the EFP and the late luteal phase and inhibin A was higher in the periovulatory phase. 'Normalization' of Day 3 FSH in women with previously elevated FSH was associated with normalization of inhibin B levels in the preceding luteal phase.
The endocrine cycle profile in younger subfertile patients with consistently elevated basal FSH resembles that in published data from older women and also reflects a low ovarian reserve. Normalization of FSH in association with normal inhibin B suggests a temporary increase of the available cohort.
在不育患者中经常观察到早卵泡期（EFP）促卵泡激素（FSH）升高。在这些女性中，已知FSH浓度会出现暂时正常化。我们研究了基础FSH升高的年轻不育女性与对照组相比的完整内分泌周期情况。
在一个月经周期内，对22例基础FSH水平升高（在筛查中确定）的患者和16例对照进行卵泡期每日采血及超声监测，并在下一周期的5天内持续监测。
11例患者在研究周期中基础FSH水平升高（“高，高”组；H，H组），而11例患者基础FSH水平正常化（“高，低”组；H，L组）。两组抗苗勒管激素（AMH）均较低。在H，H组中，周期各阶段FSH均较高，且在EFP期间抑制素A和B均较低。在H，L组中，EFP和黄体晚期FSH也高于对照组，且围排卵期抑制素A较高。先前FSH升高的女性第3天FSH“正常化”与前一黄体期抑制素B水平正常化相关。
基础FSH持续升高的年轻不育患者的内分泌周期情况与老年女性已发表的数据相似，也反映了卵巢储备功能低下。FSH正常化且抑制素B正常表明可利用卵泡群暂时增加。
