Hecht B R, Bardawil W A, Khan-Dawood F S, Dawood M Y
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
Am J Obstet Gynecol. 1990 Dec;163(6 Pt 1):1986-91. doi: 10.1016/0002-9378(90)90785-6.
Midluteal phase endometrium was histologically dated with midcycle luteinizing hormone surge time in 29 cycles from 10 parous women during untreated cycles (control) and treatment with clomiphene citrate 50 mg and 150 mg daily on days 5 through 9. Integrated progesterone output for 7 days after luteinizing hormone surge calculated from the daily plasma progesterone levels was 66.6 +/- 9.8 ng/ml in the control group compared with 117.5 +/- 18.6 ng/ml for clomiphene citrate 50 mg treatment and 152.1 +/- 11 ng/ml for clomiphene citrate 150 mg treatment (p less than or equal to 0.05). Only one cycle (clomiphene citrate 150 mg) had an out-of-phase endometrium and a significantly reduced integrated progesterone output of 28 ng/ml. All other cycles showed synchronous endometrial maturation. We conclude that luteal insufficiency as a result of clomiphene citrate treatment in ovulatory women is infrequent and is more likely to be a result of functional outcome of a relative lack of luteal phase progesterone output.
在10名经产妇未治疗周期（对照组）以及第5至9天每天使用50毫克和150毫克枸橼酸氯米芬治疗的29个周期中，对黄体中期子宫内膜进行组织学检查，并与月经周期中期促黄体生成素激增时间进行对照。根据每日血浆孕酮水平计算，促黄体生成素激增后7天的综合孕酮输出量在对照组中为66.6±9.8纳克/毫升，而枸橼酸氯米芬50毫克治疗组为117.5±18.6纳克/毫升，枸橼酸氯米芬150毫克治疗组为152.1±11纳克/毫升（p≤0.05）。只有一个周期（枸橼酸氯米芬150毫克）出现子宫内膜不同步，综合孕酮输出量显著降低至28纳克/毫升。所有其他周期均显示子宫内膜同步成熟。我们得出结论，排卵妇女因枸橼酸氯米芬治疗导致黄体功能不全的情况很少见，更可能是黄体期孕酮输出相对不足的功能结果。
