Kekkonen R, Alfthan H, Haukkamaa M, Heikinheimo O, Luukkainen T, Lähteenmäki P
University of Helsinki, Finland.
Fertil Steril. 1990 Apr;53(4):747-50.
Seven healthy women were treated with the antiprogesterone RU486, 25 mg/d, on days 1 to 14 of the follicular phase of the menstrual cycle, followed by the synthetic progestin NET in the luteal phase of the cycle. Venous blood samples were collected twice per week. Serum E2, P, and RU486 concentrations were determined by RIAs, and FSH and LH by immunofluorometric assays. Ultrasonography was used to measure the sizes of the follicles. Serum concentrations of FSH and LH were not suppressed during the treatment. Ovulation was apparently suppressed during RU486 treatment according to E2 and P concentrations and ultrasonography findings. During NET treatment, some evidence of ovulation and follicle growth were found during the first treatment periods. During the third treatment cycle, there was no evidence of ovulation (n = 2). Estradiol concentrations were sufficient to stimulate normal proliferative growth of the endometrium during the treatment. Control of bleeding was good. The exact mechanism of action of RU486 on steroid synthesis and ovulation is not clear, but it appears to act at the ovarian level. The evidence indicates that sequential RU486/progestin treatment could be developed to result in suppression of follicular growth and ovulation.
7名健康女性在月经周期卵泡期的第1至14天接受抗孕激素RU486治疗，剂量为25毫克/天，随后在周期的黄体期接受合成孕激素炔诺酮治疗。每周采集两次静脉血样。通过放射免疫分析法测定血清雌二醇（E2）、孕酮（P）和RU486浓度，通过免疫荧光分析法测定促卵泡生成素（FSH）和促黄体生成素（LH）。使用超声检查测量卵泡大小。治疗期间血清FSH和LH浓度未受到抑制。根据E2和P浓度以及超声检查结果，在RU486治疗期间排卵明显受到抑制。在炔诺酮治疗期间，在首个治疗周期发现了一些排卵和卵泡生长的迹象。在第三个治疗周期，没有排卵迹象（n = 2）。治疗期间雌二醇浓度足以刺激子宫内膜正常增殖生长。出血控制良好。RU486对类固醇合成和排卵的确切作用机制尚不清楚，但它似乎在卵巢水平起作用。证据表明，序贯使用RU486/孕激素治疗可能会抑制卵泡生长和排卵。
