Homburg R, Eshel A, Kilborn J, Adams J, Jacobs H S
Cobbold Laboratories, Middlesex Hospital, London, UK.
Hum Reprod. 1990 Jan;5(1):32-5. doi: 10.1093/oxfordjournals.humrep.a137035.
This study was designed to compare the results of treatment with, firstly, exogenous gonadotrophins, with (57 cycles) and without (65 cycles) pretreatment with a superactive analogue of luteinizing hormone releasing hormone (LHRH) and, secondly, pure follicle stimulating hormone (FSH) (50 cycles) with those of human menopausal gonadotrophin (HMG) (72 cycles) in 46 women with clomiphene-citrate-resistant anovulation associated with polycystic ovaries. Patients randomly allocated to the analogue group received buserelin (Suprefact, Hoechst, UK, Ltd, Hounslow, Middlesex), 800 micrograms/day by nasal insufflation and when hypogonadism was achieved, patients were again randomly allocated for ovarian stimulation with either FSH or HMG. Controls received FSH or HMG alone. Patients pretreated with the analogue had similar pregnancy and ovulation rates, needed larger doses and more days of gonadotrophin therapy and had more ovarian overstimulation than those receiving no pretreatment. The role of superactive LHRH analogues for induction of a single ovulation for in-vivo fertilization is thus uncertain. Pure FSH had no advantages over HMG, the LH content of HMG having no deleterious effect on the ovary.
本研究旨在比较治疗结果，首先是外源性促性腺激素，分为使用（57个周期）和不使用（65个周期）促黄体生成素释放激素（LHRH）超活性类似物进行预处理的情况，其次是比较46例克罗米芬枸橼酸盐抵抗性无排卵伴多囊卵巢综合征女性中，使用纯促卵泡激素（FSH）（50个周期）与使用人绝经期促性腺激素（HMG）（72个周期）的治疗结果。随机分配至类似物组的患者接受布舍瑞林（Suprefact，英国赫斯特有限公司，豪恩斯洛，米德尔塞克斯），通过鼻腔喷雾给药，剂量为800微克/天，当出现性腺功能减退时，患者再次随机分配接受FSH或HMG进行卵巢刺激。对照组仅接受FSH或HMG。与未接受预处理的患者相比，接受类似物预处理的患者妊娠率和排卵率相似，但需要更大剂量和更长天数的促性腺激素治疗，且卵巢过度刺激的情况更多。因此，超活性LHRH类似物在诱导体内受精单次排卵中的作用尚不确定。纯FSH相对于HMG并无优势，HMG中的LH成分对卵巢没有有害影响。
