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在卵泡晚期给予LHRH拮抗剂进行治疗时,其对排卵周期的抑制作用会降低。

Inhibitory effects of treatment with an LHRH antagonist on the ovulatory cycle are reduced when administered during the late follicular phase.

作者信息

Fraser H M

机构信息

MRC Reproductive Biology Unit, Centre for Reproductive Biology, Edinburgh, UK.

出版信息

Contraception. 1990 Jan;41(1):73-83. doi: 10.1016/0010-7824(90)90128-i.

Abstract

To compare the effects of transitory suppression of pituitary gonadotropin secretion by an LHRH antagonist at the mid or late follicular phase of the menstrual cycle, adult macaques with normal menstrual cycles were treated with an LHRH antagonist (N-Ac-D-Nal(2)1,D-pCl-Phe2,D-Trp3,D-hArg(Et2)6,D-Ala10 ]LHRH (detirelix) administered subcutaneously at a dose of 300 micrograms/kg, daily for 3 days beginning either during the mid or late follicular phase. In all eight animals treated during the mid follicular phase, serum concentrations of LH and FSH declined and remained suppressed for 4 days. This caused a fall in serum concentrations of estradiol and the expected ovulation failed to occur. During the recovery period a marked rise in serum FSH occurred followed by normal follicular development and ovulation 14.8 +/- 0.6 days after the last injection of antagonist. Of the 9 macaques given the same treatment during the late follicular phase, only in two was the expected rise in serum progesterone prevented. In 4 of the animals a transitory suppression in LH and estradiol was observed but this was followed by a recovery and occurrence of an LH surge and rise in serum progesterone indicating ovulation during the course of treatment. In the remaining 3 macaques treatment commenced on the day of the initiation of the LH surge and was associated with a progesterone rise of normal duration but lower than normal magnitude during the early luteal phase. These results show that LHRH antagonist treatment causes rapid inhibition of pituitary-ovarian function when administered up to the mid follicular phase of the cycle and is effective in blocking ovulation. The suppressive effects of the antagonist are reduced when administered during the late follicular phase. This may be due to decreased dependence of the pituitary gonadotrope on LHRH at this time and on decreased dependence of the dominant follicle on the gonadotropins.

摘要

为比较促黄体生成素释放激素(LHRH)拮抗剂在月经周期卵泡期中期或晚期对垂体促性腺激素分泌的短暂抑制作用,对月经周期正常的成年猕猴,从卵泡期中期或晚期开始,皮下注射LHRH拮抗剂[N - 乙酰 - D - 萘丙氨酸(2)1,D - 对氯苯丙氨酸2,D - 色氨酸3,D - 高精氨酸(乙基)6,D - 丙氨酸10]促性腺激素释放激素(地瑞林),剂量为300微克/千克,每日1次,共3天。在卵泡期中期接受治疗的所有8只动物中,促黄体生成素(LH)和促卵泡生成素(FSH)的血清浓度下降并持续被抑制4天。这导致雌二醇血清浓度下降,预期的排卵未能发生。在恢复期,血清FSH显著升高,随后在最后一次注射拮抗剂后14.8±0.6天出现正常的卵泡发育和排卵。在卵泡期晚期接受相同治疗的9只猕猴中,只有2只的血清孕酮预期升高被阻止。在4只动物中观察到LH和雌二醇的短暂抑制,但随后恢复,出现LH峰和血清孕酮升高,表明在治疗过程中发生了排卵。其余3只猕猴在LH峰开始当天开始治疗,黄体早期孕酮升高持续时间正常,但幅度低于正常。这些结果表明,在月经周期卵泡期中期之前给予LHRH拮抗剂治疗可迅速抑制垂体 - 卵巢功能,并有效阻断排卵。在卵泡期晚期给予拮抗剂时,其抑制作用减弱。这可能是由于此时垂体促性腺细胞对LHRH的依赖性降低,以及优势卵泡对促性腺激素的依赖性降低。

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