Martikainen H, Rönnberg L, Tapanainen J, Puistola U, Orava M, Kauppila A
Department of Obstetrics and Gynaecology, University of Oulu, Finland.
Hum Reprod. 1990 Apr;5(3):246-9. doi: 10.1093/oxfordjournals.humrep.a137081.
A treatment regime comprising an intranasally administered luteinizing hormone-releasing hormone (LHRH) agonist analogue (buserelin) on cycle days 1-4, followed by gonadotrophin administration [follicle stimulating hormone (FSH)/human menopausal gonadotrophin (HMG)] resulted in identical oestradiol (E2) responses compared with the reference method using clomiphene citrate (CC) and gonadotrophins. Immediately after analogue administration (day 4), buserelin-treated women showed short-lived elevations in serum LH and progesterone concentrations, but in the later follicular phase, the serum LH concentration was lowered compared with the controls. None of the women treated with analogue displayed elevated serum LH or progesterone concentrations at the time of injection of human chorionic gonadotrophin. In the early luteal phase, these women had higher serum levels of progesterone and higher progesterone to E2 ratios than the controls, but the length of the luteal phase was slightly shortened. Hence, in hyperstimulated cycles, 4-day treatment with buserelin caused profound endocrinological changes: namely, short-term rescue of the corpus luteum, prevention of an endogenous LH rise and premature luteinization and increased progesterone production in the early luteal phase.
一种治疗方案，即在月经周期第1 - 4天经鼻给予促黄体生成激素释放激素（LHRH）激动剂类似物（布舍瑞林），随后给予促性腺激素[促卵泡生成素（FSH）/人绝经期促性腺激素（HMG）]，与使用枸橼酸氯米芬（CC）和促性腺激素的参考方法相比，其雌二醇（E2）反应相同。在给予类似物后即刻（第4天），布舍瑞林治疗的女性血清LH和孕酮浓度出现短暂升高，但在卵泡期后期，与对照组相比血清LH浓度降低。在注射人绒毛膜促性腺激素时，接受类似物治疗的女性均未出现血清LH或孕酮浓度升高。在黄体早期，这些女性的血清孕酮水平较高，孕酮与E2的比值也高于对照组，但黄体期长度略有缩短。因此，在超刺激周期中，布舍瑞林4天治疗引起了深刻的内分泌变化：即黄体的短期挽救、内源性LH升高及过早黄体化的预防以及黄体早期孕酮产生增加。
