Martikainen H, Rönnberg L, Ruokonen A, Kauppila A
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Fertil Steril. 1991 Oct;56(4):641-5. doi: 10.1016/s0015-0282(16)54593-2.
To elucidate gonadotropin secretory patterns during ovarian hyperstimulation for in vitro fertilization.
All volunteers who attended the unit during a period of 3 months were prospectively investigated.
Infertility unit of the University Central Hospital of Oulu.
Normally menstruating tubal infertility patients (n = 8) and healthy women with ovulatory cycles (hospital personnel, n = 11). All patients finished the study.
Clomiphene citrate (CC), 50 mg, was administered on cycle days 5 to 9 and 300 IU of pure follicle-stimulating hormone (FSH) on cycle day 7 and 150 IU on cycle day 8.
Serum samples for luteinizing hormone (LH) and FSH measurements were collected at 10-minute intervals for 6 hours on cycle day 7 (effect of CC) and day 9 (effect of CC/FSH), and the data were analyzed with the Munro computer program.
The number of LH peaks was identical in the controls and study subjects on cycle days 7 and 9, whereas the pulse amplitude (P less than 0.025) and the pulse area (P less than 0.01) were higher in the CC/FSH-treated patients. The increase in overall mean LH level during the hormone therapy was not significant. In the CC/FSH-treated women, a decreased number of FSH pulses (P less than 0.01) with increased amplitude (P less than 0.001) and pulse area (P less than 0.01) was found. Clomiphene citrate treatment increased the mean FSH level (control versus cycle day 7, P less than 0.05) which was further increased (cycle day 7 versus cycle day 9, P less than 0.05) by FSH administration on cycle days 7 to 8. Otherwise pure FSH was found to be unable to modify endogenous LH or FSH secretory patterns under these conditions.
Clomiphene citrate increases the amplitudes of both LH and FSH pulses in the midfollicular phase of a stimulated cycle, an effect which is not influenced by pure FSH administration.
阐明体外受精卵巢过度刺激过程中促性腺激素的分泌模式。
对在3个月期间到该科室就诊的所有志愿者进行前瞻性研究。
奥卢大学中心医院不孕症科室。
月经正常的输卵管性不孕症患者（n = 8）和有排卵周期的健康女性（医院工作人员，n = 11）。所有患者均完成了研究。
在周期第5至9天给予50 mg枸橼酸氯米芬（CC），在周期第7天给予300 IU纯促卵泡激素（FSH），在周期第8天给予150 IU。
在周期第7天（CC的作用）和第9天（CC/FSH的作用），每隔10分钟采集一次血清样本用于测定黄体生成素（LH）和FSH，并使用Munro计算机程序分析数据。
在周期第7天和第9天，对照组和研究对象的LH峰值数量相同，而在接受CC/FSH治疗的患者中，脉冲幅度（P < 0.025）和脉冲面积（P < 0.01）更高。激素治疗期间LH总体平均水平的升高不显著。在接受CC/FSH治疗的女性中，发现FSH脉冲数量减少（P < 0.01），而幅度（P < 0.001）和脉冲面积（P < 0.01）增加。枸橼酸氯米芬治疗使平均FSH水平升高（对照组与周期第7天相比，P < 0.05），在周期第7至8天给予FSH后进一步升高（周期第7天与周期第9天相比，P < 0.05）。否则，发现在这些条件下纯FSH无法改变内源性LH或FSH的分泌模式。
枸橼酸氯米芬可增加刺激周期卵泡中期LH和FSH脉冲的幅度，这一作用不受纯FSH给药的影响。
