Mizunuma H, Takagi T, Yamada K, Andoh K, Ibuki Y, Igarashi M
Department of Obstetrics and Gynecology, Gunma University School of Medicine, Japan.
Fertil Steril. 1991 Jan;55(1):66-72.
Patients with polycystic ovarian disease were grouped into three groups according to their maximum ovarian diameter (maxD) after ovulation induction by purified urinary follicle-stimulating hormone (FSH). Serum luteinizing hormone (LH) and FSH were measured daily by radioimmunoassay and size and number of follicles were assessed by ultrasonography. Follicle-stimulating hormone in group A (80 mm less than or equal to maxD) was significantly higher than those of group B (60 mm less than or equal to maxD less than 80 mm) and C (maxD less than 60 mm) for the last 4 days of the treatment. This FSH rise in group A was not accounted for by FSH accumulation by the study of pharmacodynamics, and so was thought to be of endogenous origin. Luteinizing hormone was also elevated 3 days before the administration of human chorionic gonadotropin (hCG) in both groups A and B. The number of follicles in group A at hCG administration was significantly greater than that of group C. Any significant differences were not found in either total amount of purified urinary FSH or in the basal FSH and the LH levels before treatment of the three groups. These results suggest that excessive ovarian enlargement during gonadotropin therapy is caused by multiple follicular development primarily stimulated by endogenous FSH. Endogenous LH release further enhances ovarian enlargement.
多囊卵巢疾病患者根据经纯化尿促卵泡素（FSH）诱导排卵后的最大卵巢直径（maxD）分为三组。每天通过放射免疫测定法测定血清促黄体生成素（LH）和FSH，并通过超声检查评估卵泡的大小和数量。在治疗的最后4天，A组（80mm≤maxD）的促卵泡素明显高于B组（60mm≤maxD＜80mm）和C组（maxD＜60mm）。通过药效学研究发现，A组中促卵泡素的升高并非由促卵泡素的蓄积所致，因此被认为是内源性的。在A组和B组中，在注射人绒毛膜促性腺激素（hCG）前3天，促黄体生成素也升高。在注射hCG时，A组的卵泡数量明显多于C组。三组在纯化尿促卵泡素的总量以及治疗前的基础促卵泡素和促黄体生成素水平方面均未发现任何显著差异。这些结果表明，促性腺激素治疗期间卵巢过度增大是由内源性促卵泡素主要刺激多个卵泡发育引起的。内源性促黄体生成素的释放进一步加剧了卵巢增大。
